NPIMap

Organization Active NPI

United Dental Centers

  • Dentist
  • Hammond, IN
National Provider Identifier
1801197868
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009174 Issued in IN
Legal business name
UNITED DENTAL CENTERS
Practice address
5254 Hohman Ave
Hammond, IN 46320-1722
Phone
(219) 933-4900
NPI assigned
Nov 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
Dr. Kenneth Fried, DDS
Title
President
Phone
(219) 933-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12009174 IN Primary

Addresses

Primary practice location

5254 Hohman Ave
Hammond, IN 46320-1722

Mailing address

5254 Hohman Ave
Hammond, IN 46320-1722
Phone (219) 933-4900

Other identifiers 1

IdentifierTypeStateIssuer
100147560BMedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
United Dental Centers7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5254 Hohman Ave
Hammond, IN 46320
Phone (219) 933-4900

Practitioners & affiliated clinicians

Practitioners 1

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": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1801197868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5254 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201722",
            "telephone_number": "219-933-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5254 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201722",
            "telephone_number": "219-933-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "FRIED",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-933-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100147560B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.