NPIMap

Organization Active NPI

Hometown Family Dental

  • Dental Clinic/Center
  • Hobart, IN
National Provider Identifier
1649987470
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HOMETOWN FAMILY DENTAL
Practice address
1005 Lincoln St
Hobart, IN 46342-6082
Phone
(219) 942-4858
Fax
(219) 942-4036
NPI assigned
Nov 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Dr. Sara Jackson, DDSNPI 1710546106
Title
Owner
Phone
(219) 942-4858

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 Primary

Addresses

Primary practice location

1005 Lincoln St
Hobart, IN 46342-6082

Mailing address

1005 Lincoln St
Hobart, IN 46342-6082
Phone (219) 942-4858

Other identifiers 1

IdentifierTypeStateIssuer
300060040MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL myhometownfamilydentist.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1649987470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 LINCOLN ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426082",
            "telephone_number": "219-942-4858",
            "fax_number": "219-942-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 LINCOLN ST",
            "city": "HOBART",
            "state": "IN",
            "postal_code": "463426082",
            "telephone_number": "219-942-4858",
            "fax_number": "219-942-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-942-4858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300060040",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "myhometownfamilydentist.com",
            "affiliation": "N",
            "address_1": "1005 Lincoln St",
            "city": "Hobart",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463426082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hobart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.