NPIMap

Organization Active NPI

Timothy S. Kulik D.D.S.,P.C.

  • Dentist
  • South Bend, IN
National Provider Identifier
1568739332
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12007358 Issued in IN
Legal business name
TIMOTHY S. KULIK D.D.S.,P.C.
Practice address
211 N Saint Peter St
South Bend, IN 46617-2823
Phone
(574) 288-1900
Fax
(574) 288-3900
NPI assigned
Nov 22, 2011
Last updated
Nov 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Authorized official

Name
Dr. Timothy Sigmund Kulik, D.D.S.NPI 1356428031
Title
Officer
Phone
(574) 288-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12007358 IN Primary

Addresses

Primary practice location

211 N Saint Peter St
South Bend, IN 46617-2823

Mailing address

211 N Saint Peter St
South Bend, IN 46617-2823
Phone (574) 288-1900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1568739332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N SAINT PETER ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172823",
            "telephone_number": "574-288-1900",
            "fax_number": "574-288-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N SAINT PETER ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172823",
            "telephone_number": "574-288-1900",
            "fax_number": "574-288-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY S. KULIK D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "KULIK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SIGMUND",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "574-288-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12007358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.