NPIMap

Organization Active NPI

Elkhart County Health Department

  • Pediatric Dentistry
  • Elkhart, IN
National Provider Identifier
1659596336
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
ELKHART COUNTY HEALTH DEPARTMENT
Practice address
1400 Hudson Street
Elkhart, IN 46516
Phone
(574) 522-0104
Fax
(574) 522-1902
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Diantha Hostetler
Title
Clinical Manager
Phone
(574) 523-2136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1400 Hudson Street
Elkhart, IN 46516

Mailing address

608 Oakland Avenue
Elkhart, IN 46516
Phone (574) 523-2105

Other identifiers 1

IdentifierTypeStateIssuer
100112150AMedicaidIN

Other names 1

  • Healthy Beginnings Other name

National Provider Directory

National Provider Directory
Tax ID family
Elkhart County Health Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1659596336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 OAKLAND AVENUE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-523-2105",
            "fax_number": "574-295-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HUDSON STREET",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-522-0104",
            "fax_number": "574-522-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "HOSTETLER",
        "authorized_official_first_name": "DIANTHA",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "574-523-2136"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112150A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Beginnings",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.