NPIMap

Organization Active NPI

Dental Health Assoc of in

  • General Practice Dentistry
  • Bloomington, IN
National Provider Identifier
1609190719
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOC OF IN
Practice address
3617 W State Road 46
Bloomington, IN 47404-9152
Phone
(812) 876-0007
NPI assigned
Mar 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Authorized official

Name
Jennifer Purvis
Title
Ar Manager
Phone
(317) 359-3888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3617 W State Road 46
Bloomington, IN 47404-9152

Mailing address

3617 W State Road 46
Bloomington, IN 47404-9152
Phone (812) 876-0007

Other names 1

  • Ellettsville Gentle Dentist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Assoc of in13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

3617 W State Road 46
Bloomington, IN 47404
Phone (812) 323-9970

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1609190719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W STATE ROAD 46",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474049152",
            "telephone_number": "812-876-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W STATE ROAD 46",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474049152",
            "telephone_number": "812-876-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOC OF IN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "PURVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "317-359-3888"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellettsville Gentle Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.