NPIMap

Organization Active NPI

Dental Professionals of Indiana, PC

Doing business as Regal Valley Dental Care

  • General Practice Dentistry
  • Lafayette, IN
National Provider Identifier
1518418680
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF INDIANA, PC
Doing business as
Regal Valley Dental Care
Practice address
2000 Veterans Memorial Parkway S
Lafayette, IN 47909
Phone
(765) 746-6166
Fax
(765) 746-6935
NPI assigned
Oct 24, 2016
Last updated
Jan 9, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF INDIANA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Authorized official

Name
Kendra Walker
Title
Credentialing Supervisor
Phone
(217) 821-7249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2000 Veterans Memorial Parkway S
Lafayette, IN 47909

Mailing address

2000 Veterans Memorial Parkway S
Lafayette, IN 47909
Phone (765) 746-6166

Other names 1

  • Regal Valley Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Indiana PC48 organizations share this tax ID, including this one
Part of
Dental Professionals of Indiana PC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

2000 Veterans Memorial Pkwy S
Lafayette, IN 47909
Phone (765) 746-6166

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1518418680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VETERANS MEMORIAL PARKWAY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47909",
            "telephone_number": "765-746-6166",
            "fax_number": "765-746-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VETERANS MEMORIAL PARKWAY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47909",
            "telephone_number": "765-746-6166",
            "fax_number": "765-746-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF INDIANA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF INDIANA, PC",
        "enumeration_date": "2016-10-24",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "217-821-7249"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regal Valley Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.