NPIMap

Organization Active NPI

Kentuckiana Dental Group

  • General Practice Dentistry
  • Seymour, IN
National Provider Identifier
1609223759
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011969 Issued in IN
Legal business name
KENTUCKIANA DENTAL GROUP
Practice address
321 W Bruce St Ste 300
Seymour, IN 47274-2319
Phone
(812) 523-1860
NPI assigned
May 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
David Shellenberger
Title
Office Manager
Phone
(502) 938-9056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12011969 IN Primary

Addresses

Primary practice location

321 W Bruce St Ste 300
Seymour, IN 47274-2319

Mailing address

PO Box 305
Seymour, IN 47274-0305
Phone (812) 523-1860

Other names 1

  • Crossings Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

321 W Bruce St
Ste 300
Seymour, IN 47274
Phone (812) 523-1860

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1609223759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472740305",
            "telephone_number": "812-523-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W BRUCE ST STE 300",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742319",
            "telephone_number": "812-523-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "SHELLENBERGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-938-9056"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossings Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.