Conner Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12011312 Issued in IN

Legal business name

CONNER DENTISTRY LLC

Doing business as

Family Dentistry of Wabash

Practice address

1146 N Cass St
Suite C
Wabash, IN 46992-1081

Phone

(260) 563-4805

Fax

(260) 563-2958

NPI assigned

Oct 25, 2011

Last updated

Oct 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John D Conner, D.D.S.NPI 1891004503

Title

Managing Member/President

Phone

(260) 563-4805

Specialties & licenses 1

Addresses

Other names 1

• Family Dentistry of Wabash Doing business as

Locations

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.

• John David Conner, D.D.S.

  • Dentist
  • Wabash, IN
  • NPI 1891004503
  Authorized official Same address or phone

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1629354428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 N CASS ST",
            "address_2": "SUITE C",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921081",
            "telephone_number": "260-563-4805",
            "fax_number": "260-563-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 N CASS ST",
            "address_2": "SUITE C",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921081",
            "telephone_number": "260-563-4805",
            "fax_number": "260-563-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNER DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "260-563-4805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of Wabash",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlyn Joy Chittick-Myers, PMHNP
• Kassady Paige Chudzicki, OD
• City of Wabash (Wabash City County Ambulance Service)
• Tara Cogdell
• Compass Rose Academy
• John David Conner, D.D.S.
• Brittany Connor, MA CCC-SLP
• Jennie Conrad, LMHC, NCC
• Brian Cooper
• Sonya Copley, SLP-CCC

• Dentist in Wabash, IN
• Providers in Wabash, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.