Provider Type Icon

THE PORTLAND DENTAL PLACE NPI 1982972790


NPI Information

NPI: 1982972790
Provider Name: THE PORTLAND DENTAL PLACE
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
112 N SHIP ST
PORTLAND, IN
ZIP 47371
Phone: (260) 726-4710
Get Directions

THE PORTLAND DENTAL PLACE is a general practice dentist in Portland, 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. THE PORTLAND DENTAL PLACE NPI is 1982972790. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

112 N SHIP ST
PORTLAND, IN
ZIP 47371-844
Phone: (260) 726-4710
Fax: (260) 726-7051

The provider's authorized official is Teresa M Watkins .
The authorized official title is Dentist and has the following contact phone number (260) 726-4710.

The enumeration date for this NPI number is 12/7/2011 and was last updated on 12/7/2011.


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 Practice12010271AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200962440MEDICAIDINDIANA
2200888510MEDICAIDINDIANA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.