Trinity Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

TRINITY DENTAL

Practice address

900 S Main St
Kendallville, IN 46755-2025

Phone

(260) 582-2607

Fax

(260) 494-1218

NPI assigned

Jun 19, 2015

Last updated

Jun 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tyrone Smith, DDS

Title

Dentist/Owner

Phone

(260) 582-2607

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1972985539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SOUTH MAIN STREET",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552525",
            "telephone_number": "260-582-2607",
            "fax_number": "260-494-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S MAIN ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467552025",
            "telephone_number": "260-582-2607",
            "fax_number": "260-494-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "260-582-2607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201025790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Tiltman
• Deborah Tipton
• Robert Francis Todaro, M.D.
• Bobby Tolosa, MD
• Elsie Torres, RBT
• Linda Tritch
• Shawna Trombley, DPT
• Adriana Uhl, MSED, LMFT
• United Anesthesia Consultants LLC.
• Luis M Velasco, M.D.

• Dentist in Kendallville, IN
• Providers in Kendallville, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.