L. Rhett Fagg, D.D.S., M.S.D., PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12007148A Issued in IN

Legal business name

L. RHETT FAGG, D.D.S., M.S.D., PC

Practice address

211 Medical PLZ
Michigan City, IN 46360-3364

Phone

(219) 879-4559

Fax

(219) 879-4559

NPI assigned

Apr 3, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Cynthia A Bechinski

Title

Staff Assistant

Phone

(219) 879-4559

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Llyndall Rhett Fagg, DDS MSD

  • Pediatric Dentistry
  • Michigan City, IN
  • NPI 1093715963
  NPD (past)

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1568635183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MEDICAL PLZ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603364",
            "telephone_number": "219-879-4559",
            "fax_number": "219-879-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MEDICAL PLZ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603364",
            "telephone_number": "219-879-4559",
            "fax_number": "219-879-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. RHETT FAGG, D.D.S., M.S.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "BECHINSKI",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "STAFF ASSISTANT",
        "authorized_official_telephone_number": "219-879-4559",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12007148A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200356670A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abbi Danae Kroll, NP
• Michelle Lynn Krsteski, PHARMD, MS
• Cheryl Krueger, FNP
• Mandavi Kulkarni, MD
• Jaroslaw Kuna, M.D.
• La Porte County Anesthesia Associates LLC
• La Porte Home Care Services LLC
• La Porte Home Care Services, LLC
• La Porte Regional Physician Network
• La Porte Regional Physician Network

• Pediatric Dentistry in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.