Kokomo Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KOKOMO FAMILY DENTAL LLC

Practice address

3416 S Dixon Rd
Kokomo, IN 46902-5642

Phone

(765) 455-1971

Fax

(765) 457-8359

NPI assigned

Nov 6, 2025

Organization subpart

No

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

Authorized official

Name

Srinivas Durshanapalli, DDS

Title

President

Phone

(888) 244-8899

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1801766878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 S DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025642",
            "telephone_number": "765-455-1971",
            "fax_number": "765-457-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 S DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025642",
            "telephone_number": "765-455-1971",
            "fax_number": "765-457-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOMO FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "DURSHANAPALLI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-244-8899",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Kokomo, IN
• Providers in Kokomo, 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 Nov 6, 2025; 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.