Organization Active NPI

Something Cool LLC

  • Periodontics
  • Lafayette, IN
National Provider Identifier
1699341420
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
SOMETHING COOL LLC
Practice address
415 N 26TH St Ste 303
Lafayette, IN 47904-2893
Phone
(765) 447-9319
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Gloria Royer
Title
Practice Manager
Phone
(765) 447-9319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X NU Primary

Addresses

Primary practice location

415 N 26TH St Ste 303
Lafayette, IN 47904-2893

Mailing address

415 N 26TH St Ste 303
Lafayette, IN 47904-2893
Phone (765) 447-9319

Other identifiers 1

IdentifierTypeStateIssuer
12013130AOtherINSTATE DENTAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Lafayette

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1699341420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST STE 303",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042893",
            "telephone_number": "765-447-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST STE 303",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042893",
            "telephone_number": "765-447-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMETHING COOL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "ROYER",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "765-447-9319"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "12013130A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Lafayette",
            "affiliation": "N",
            "address_1": "415 N 26th St Ste 303",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479042893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.