NPIMap

Organization Active NPI

Indiana TMJ Treatment Center

  • General Practice Dentistry
  • Pendleton, IN
National Provider Identifier
1912955832
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7161 Issued in IN
Legal business name
INDIANA TMJ TREATMENT CENTER
Practice address
210 East Water Street
Pendleton, IN 46064-0206
Phone
(765) 778-3332
Fax
(765) 778-4860
NPI assigned
May 4, 2006
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Dr. Kenneth Lau, D.D.S.NPI 1013002310
Title
Doctor
Phone
(765) 778-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7161 IN Primary

Addresses

Primary practice location

210 East Water Street
Pendleton, IN 46064-0206

Mailing address

210 East Water Street
P.O. Box 206
Pendleton, IN 46064-0206
Phone (765) 778-3332

National Provider Directory

National Provider Directory

Locations

210 E Water St
Pendleton, IN 46064
Phone (765) 778-3332

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1912955832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 EAST WATER STREET",
            "address_2": "P.O. BOX 206",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460640206",
            "telephone_number": "765-778-3332",
            "fax_number": "765-778-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EAST WATER STREET",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460640206",
            "telephone_number": "765-778-3332",
            "fax_number": "765-778-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA TMJ TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "765-778-3332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.