Organization Active NPI

Columbia Family Dentistr

  • General Practice Dentistry
  • Evansville, IN
National Provider Identifier
1992034102
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
IN8273 Issued in IN
Legal business name
COLUMBIA FAMILY DENTISTR
Practice address
6231 E Columbia St
Evansville, IN 47715-4003
Phone
(812) 476-9281
Fax
(812) 491-3844
NPI assigned
Dec 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Authorized official

Name
David M Hubert, DDSNPI 1508084328
Title
Owner
Phone
(812) 476-9281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IN8273 IN Primary

Addresses

Primary practice location

6231 E Columbia St
Evansville, IN 47715-4003

Mailing address

6231 E Columbia St
Evansville, IN 47715-4003
Phone (812) 476-9281

Other identifiers 1

IdentifierTypeStateIssuer
1508084328MedicaidIN

National Provider Directory

National Provider Directory

Locations

6231 E Columbia St
Evansville, IN 47715
Phone (812) 476-9281

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1992034102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6231 E COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154003",
            "telephone_number": "812-476-9281",
            "fax_number": "812-491-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6231 E COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154003",
            "telephone_number": "812-476-9281",
            "fax_number": "812-491-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA FAMILY DENTISTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "HUBERT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-476-9281",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "IN8273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508084328",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.