PKR Endodontics, P.C.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12009839A Issued in IN

Legal business name

PKR ENDODONTICS, P.C.

Practice address

8809 W 400 N
Michigan City, IN 46360-9330

Phone

(219) 879-2300

Fax

(219) 879-6420

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Philip Karl Radtke, D.D.S.

Title

President

Phone

(219) 879-2300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669569893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8809 W 400 N",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609330",
            "telephone_number": "219-879-2300",
            "fax_number": "219-879-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8809 W 400 N",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463609330",
            "telephone_number": "219-879-2300",
            "fax_number": "219-879-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PKR ENDODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADTKE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "KARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-879-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12009839A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Endodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.