King Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KING FAMILY DENTAL LLC

Doing business as

King Dental Group

Practice address

902 County Road 6 E
Elkhart, IN 46514-5571

Phone

(574) 293-7032

NPI assigned

Sep 8, 2025

Last updated

Sep 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian King, DDSNPI 1093878746

Title

Owner

Phone

(574) 293-7032

Specialties & licenses 2

Addresses

Other names 1

• King Dental Group Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 2

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.

• Brian J King

  • General Practice Dentistry
  • Elkhart, IN
  • NPI 1093878746
  NPD Authorized official
• Mark Corn, D.D.S.

  • General Practice Dentistry
  • Elkhart, IN
  • NPI 1528106432
  NPD (past)

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1679454714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 COUNTY ROAD 6 E",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465145571",
            "telephone_number": "574-293-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 COUNTY ROAD 6 E",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465145571",
            "telephone_number": "574-293-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-293-7032",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Theresa Louise Kiefer, COTA
• George S Kim, MD
• Kara Kimes
• Rebecca Kimmell
• Cameron Kincaid
• Brian J King
• Skyler King, D.O.
• Alayna Kingsbury, RBT
• Lisa Kirkton
• Angela Kirori

• General Practice Dentistry in Elkhart, IN
• Providers in Elkhart, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.