NPIMap

Organization Active NPI

Kendallville Family Dentistry LLC

  • Dental Clinic/Center
  • Kendallville, IN
National Provider Identifier
1790504041
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KENDALLVILLE FAMILY DENTISTRY LLC
Practice address
1843 Ida Red Rd
Kendallville, IN 46755-2873
Phone
(260) 343-0568
NPI assigned
Oct 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
David M Griffith, DDSNPI 1275845422
Title
Owner
Phone
(248) 425-8825

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1843 Ida Red Rd
Kendallville, IN 46755-2873

Mailing address

111 Eagle Cliff CV
Huntertown, IN 46748-9288
Phone (248) 425-8825

National Provider Directory

National Provider Directory

Locations

1843 Ida Red Rd
Kendallville, IN 46755
Phone (260) 343-0568

Practitioners & affiliated clinicians

Practitioners 2

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": "1728000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1790504041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EAGLE CLIFF CV",
            "city": "HUNTERTOWN",
            "state": "IN",
            "postal_code": "467489288",
            "telephone_number": "248-425-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 IDA RED RD",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552873",
            "telephone_number": "260-343-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALLVILLE FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-425-8825",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.