NPIMap

Organization Active NPI

Myofunctional Therapy Centre, LLC

  • Dental Clinic/Center
  • Granger, IN
National Provider Identifier
1629584362
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MYOFUNCTIONAL THERAPY CENTRE, LLC
Practice address
1245 E University Dr
Granger, IN 46530-4292
Phone
(574) 968-5166
Fax
(877) 317-3186
NPI assigned
Dec 18, 2017
Last updated
Dec 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Authorized official

Name
Daniel G KlauerNPI 1740592179
Title
Owner
Phone
(574) 968-5166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

1245 E University Dr
Granger, IN 46530-4292

Mailing address

1245 E University Dr
Granger, IN 46530-4292
Phone (574) 968-5166

National Provider Directory

National Provider Directory

Locations

1245 E University Dr
Granger, IN 46530
Phone (574) 968-5166

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": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1629584362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 E UNIVERSITY DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304292",
            "telephone_number": "574-968-5166",
            "fax_number": "877-317-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 E UNIVERSITY DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304292",
            "telephone_number": "574-968-5166",
            "fax_number": "877-317-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOFUNCTIONAL THERAPY CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "KLAUER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-968-5166"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

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