Gary R. Pippenger, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12006740 Issued in IN

Practice address

1005 E Lasalle Ave
South Bend, IN 46617-2818

Phone

(574) 245-7503

Fax

(574) 245-7502

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Dental Center of South Bend LLC

  • Pediatric Dentistry
  • South Bend, IN
  • NPI 1538184460
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1568481950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "574-245-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "574-245-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPPENGER",
        "first_name": "GARY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12006740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pilcher, OTR
• Pillars Care LLC
• Cynthia Ann Pinkowski, M.S.
• Sarah A Pinter, LCSW
• Kylie Piper, RBT
• Catherine Marie Pittman, PH.D., HSPP
• Julie Gaydos Plagens, DDS
• Plastic Surgery Center, P.C.
• Michael B Platt, M.D.
• Sarah Platte, RN

• Pediatric Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.