Dyer Family Dental Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19025070

Legal business name

DYER FAMILY DENTAL INC.

Practice address

890 Richard Rd
Dyer, IN 46311-1779

Phone

(708) 869-8662

NPI assigned

Jun 13, 2017

Organization subpart

No

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

Authorized official

Name

Kevin Lloyd Fatland, DMD

Title

Dentist/President

Phone

(708) 839-8662

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1629508734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 PINEVIEW LN",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604239004",
            "telephone_number": "708-839-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 RICHARD RD",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111779",
            "telephone_number": "708-869-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYER FAMILY DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "FATLAND",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "708-839-8662",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": "19025070",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josilyn Dunn
• Derrick Durrah, LPC
• Christina M Dust, LMFT
• Dyer Dental Professionals, Inc.
• Dyer Dental, LLC
• Dyer Family Dentistry
• Dyer Medical Center, Inc.
• Dyer Volunteer Fire Department
• Ellis Orthodontics, LLC
• Lawrence C. Ellis, DDS, MSD

• General Practice Dentistry in Dyer, IN
• Providers in Dyer, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.