Indiana TMJ Treatment Center

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

Organization subpart

No

Name

Dr. Kenneth Lau, D.D.S.

Title

Doctor

Phone

(765) 778-3332

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 20, 2009.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "000000196290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Pendleton, IN
• General Practice Dentistry in Indiana

• 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.