Secure Dental IX LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SECURE DENTAL IX LLC

Practice address

2381 E 80TH Ave
Merrillville, IN 46410-5722

Phone

(309) 606-5008

NPI assigned

Jan 11, 2019

Organization subpart

No

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

Authorized official

Name

Nazish Hasan Jafri

Title

Dentist Owner

Phone

(309) 606-5008

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1932672052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 RIVERSIDE DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616112068",
            "telephone_number": "309-606-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 E 80TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105722",
            "telephone_number": "309-606-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE DENTAL IX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "JAFRI",
        "authorized_official_first_name": "NAZISH",
        "authorized_official_middle_name": "HASAN",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "309-606-5008"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn R Scott
• Jasmine Scott
• Kenneth James Scott, RN, FNP
• T'Nazja Scott
• Shenley M Seabrook, LMHC, BCBA
• Monika Marie Segally
• Leann Christine Seip, LCSW
• Theresa Seles, HIS
• Frances Seller, D.D.S.
• Jennifer Sellers, APRN

• General Practice Dentistry in Merrillville, IN
• Providers in Merrillville, 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 Jan 11, 2019; 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.