NPIMap

Organization Active NPI

North Vernon Family Dental LLC

  • Dentist
  • North Vernon, IN
National Provider Identifier
1669820643
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012474A Issued in IN
Legal business name
NORTH VERNON FAMILY DENTAL LLC
Practice address
623 N State St
North Vernon, IN 47265-1043
Phone
(812) 346-6884
Fax
(812) 346-1717
NPI assigned
May 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Dipesh Sitaram, DDSNPI 1477637296
Title
Owner
Phone
(812) 342-9666

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12012474A IN Primary

Addresses

Primary practice location

623 N State St
North Vernon, IN 47265-1043

Mailing address

623 N State St
North Vernon, IN 47265-1043
Phone (812) 346-6884

National Provider Directory

National Provider Directory

Locations

623 N State St
North Vernon, IN 47265
Phone (812) 346-6884

Practitioners & affiliated clinicians

Practitioners 3

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": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1669820643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N STATE ST",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472651043",
            "telephone_number": "812-346-6884",
            "fax_number": "812-346-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N STATE ST",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472651043",
            "telephone_number": "812-346-6884",
            "fax_number": "812-346-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VERNON FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "SITARAM",
        "authorized_official_first_name": "DIPESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-342-9666",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012474A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Vernon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.