Tree of Life P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TREE OF LIFE P.C.

Practice address

311 Florence Ave
Granger, IN 46530-8049

Phone

(574) 232-2992

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Kelly Weber

Title

Office Admin

Phone

(574) 232-2992

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613347200000",
    "number": "1831701044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 FLORENCE AVE",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 FLORENCE AVE",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308049",
            "telephone_number": "574-232-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "574-232-2992"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Granger, IN
• Providers in Granger, IN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.