Perio Plastic & Implantology Center of Kokomo

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12011521A Issued in IN

Legal business name

PERIO PLASTIC & IMPLANTOLOGY CENTER OF KOKOMO

Practice address

3415 S Lafountain St
Suite H
Kokomo, IN 46902-3802

Phone

(765) 455-0085

NPI assigned

Jul 7, 2015

Last updated

Jul 7, 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. John Ladd, DDSNPI 1982628194

Title

Owner

Phone

(765) 455-0085

Specialties & licenses 2

Addresses

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.

• John R. Ladd

  • General Practice Dentistry
  • Kokomo, IN
  • NPI 1982628194
  Authorized official Same address or phone

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1982087078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 W LINCOLN RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469028012",
            "telephone_number": "765-455-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S LAFOUNTAIN ST",
            "address_2": "SUITE H",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023802",
            "telephone_number": "765-455-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO PLASTIC & IMPLANTOLOGY CENTER OF KOKOMO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "LADD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-455-0085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "IN",
            "license": "12011521A",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12011521A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb James Pemberton, FNP-C
• Anthony M. Pena, CHT, OT, LPN
• Rayaija Peoples, RBT
• Candace Nicole Perez
• Emma Lynn Perez
• Charlotte J Perkins
• Debra Kay Perkins, N.P.
• Alisha A. Perryman, FNP-C
• Personal Care Ambulance Transport, LLC
• Gabrielle Ann Peterman, NP

• Periodontics in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.