The Muncie Dental Place L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010271A Issued in IN

Legal business name

THE MUNCIE DENTAL PLACE L.L.C.

Practice address

1804 W McGalliard Rd
Muncie, IN 47304-2209

Phone

(765) 282-5655

Fax

(765) 587-0103

NPI assigned

Nov 17, 2011

Last updated

Nov 17, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Teresa Michelle Watkins, D.D.S.

Title

Owner

Phone

(765) 282-5655

Specialties & licenses 2

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1508133638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042209",
            "telephone_number": "765-282-5655",
            "fax_number": "765-587-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W MCGALLIARD RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473042209",
            "telephone_number": "765-282-5655",
            "fax_number": "765-587-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MUNCIE DENTAL PLACE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-282-5655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011056A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010271A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200888510",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200962440",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simant Singh Thapa, MD
• Jordan Lynn Tharp, CAA
• Karen L Thatcher, ED.D., CCC-SLP
• The Dental Place
• The Health and Hospital Corporation of Marion County (Waters Edge Village)
• Thomas C. Rector D.D.S. Inc
• Thomas E Murray Et Al PTR (Briarwood Clinic, The)
• Thomas E Strayer MD
• Thomas J Furnish (Royale Pharmacy)
• Thomas J. Melham MD LLC

• General Practice Dentistry in Muncie, IN
• Providers in Muncie, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.