FAIRMOUNT FAMILY DENTIST NPI 1518412139

NPI Information

NPI: 1518412139
Provider Name: FAIRMOUNT FAMILY DENTIST
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
215 E WASHINGTON ST
FAIRMOUNT, IN
ZIP 46928
Phone: (765) 948-4107
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FAIRMOUNT FAMILY DENTIST is a dental clinic center in Fairmount, IN. FAIRMOUNT FAMILY DENTIST NPI is 1518412139. The provider is registered as an organization entity type.

The provider's business location address is:

215 E WASHINGTON ST
FAIRMOUNT, IN
ZIP 46928-747
Phone: (765) 948-4107

The provider's authorized official is David J Shock .
The authorized official title is Owner and has the following contact phone number (765) 948-4107.

The enumeration date for this NPI number is 8/24/2016 and was last updated on 8/24/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	12011164A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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