LIFETIME DENTAL CARE OF INDIANA NPI 1780897009

NPI Information

  • NPI: 1780897009
  • Provider Name: LIFETIME DENTAL CARE OF INDIANA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: SOUTH STREET FAMILY DENTAL
  • Address: 103 NORTH FARABEE DRIVE
    SUITE C
    LAFAYETTE, IN
    ZIP 47905
  • Phone: (765) 447-7200

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NPI Details

LIFETIME DENTAL CARE OF INDIANA is a general practice dentist in Lafayette, IN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. LIFETIME DENTAL CARE OF INDIANA NPI is 1780897009. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As South Street Family Dental.

The provider's business location address is:

103 NORTH FARABEE DRIVE
SUITE C
LAFAYETTE, IN
ZIP 47905
Phone: (765) 447-7200
Fax: (765) 449-0976

The provider's authorized official is Amy Kroeger .
The authorized official title is Ins Cood and has the following contact phone number (217) 540-5100.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 8/22/2020.

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
11223G0001XDentistGeneral PracticeYes

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: 3/30/2025

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