PURDUE UNIVERSITY (NPI# 1326249376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326249376 |
| Entity Type | Organization |
| Organization Name | PURDUE UNIVERSITY |
| Other Organization Name | LAFAYETTE STREET DENTAL CLINIC |
| Practice Address |
2700 South Lafayette Street Fort Wayne IN 46806 |
| Mailing Address |
601 Stadium Mall Drive West Lafayette IN 47907-2052 |
| Practice Telephone | 2607441188 |
| Mailing Telephone | 7654961927 |
| Mailing Fax Number | 7654961227 |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2008-07-23 |
| Authorized Official Name | MS. JOAN M VAUGHAN (DIRECTOR HIPAA PRIVACY COMPLIANCE) |
| Authorized Official Telephone | 7654961927 |
| Is Organization Subpart | Y |
| Parent Organization Name | PURDUE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lafayette Street Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295104669 | Purdue University | Clinic/Center | 425 E 5th Street, Suite B, Burlington, IN 46915 | 2015-09-16 |
| 1154622512 | Purdue University | Clinic/Center | 2200 169th St, Hammond, IN 46323-2068 | 2010-11-16 |
| 1245474782 | Purdue University | Pharmacy | 625 Harrison St, West Lafayette, IN 47907-2026 | 2009-04-28 |
| 1871794826 | Purdue University | Clinic/Center | 420 N Market St, Monon, IN 47959-9799 | 2007-05-29 |
| 1780885731 | Purdue University | Clinic/Center | 509 North Street, Lafayette, IN 47901 | 2007-05-29 |
| 1053512004 | Purdue University | Dentist | 2101 East Coliseum Boulevard, Neff Hall Room 109, Fort Wayne, IN 46805-1499 | 2007-05-29 |
| 1477549731 | Purdue University | Clinic/Center | 901 Prince William Rd, Suite A, Delphi, IN 46923-1759 | 2005-09-22 |
| 1225584295 | Purdue University | Nurse Practitioner | 2101 E Coliseum Blvd, Wu 234, Fort Wayne, IN 46805-1445 | 2016-08-30 |
| 1598111791 | Purdue University | Clinic/Center | 128 W Market St, Wolcott, IN 47995-8130 | 2016-05-06 |
| 1679917710 | Purdue University | Clinic/Center | 2101 E Coliseum Blvd, Walb Union 234, Fort Wayne, IN 46805-1445 | 2013-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PURDUE UNIVERSITY | 155 S Grant St, West Lafayette, IN 47907-2114 |
| Virginia Business Entities | Purdue University Global Inc. | 9000 Keystone Xing Ste 800, Indianapolis, Indiana 46240 |
| Oregon Corporations, Companies and Business Names | PURDUE UNIVERSITY GLOBAL, INC. | 9000 Keystone, #800, Indianapolis, IN 46240 |
| Colorado Business Entities | Purdue University Global, Inc. | 9000 Keystone, #800, Indianapolis, IN 46240 |
| Iowa Business Entities | PURDUE UNIVERSITY GLOBAL, INC. | 9000 Keystone, 800, Indianapolis, IN 46240 |
| Connecticut Business Registrations | PURDUE UNIVERSITY GLOBAL, INC. | 9000 Keystone Crossing #800, Indianapolis, IN 46240 |
| Washington State Corporations | PURDUE UNIVERSITY GLOBAL, INC. | 9000 Keystone, #800, Indianapolis, IN 46240 |
| Street Address |
2700 SOUTH LAFAYETTE STREET |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508069972 | Indiana University | Clinic/Center | 2700 South Lafayette Street, Fort Wayne, IN 46806 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841574829 | Daniel E Purvis Jr. | Pharmacist | 222 E Pettit Avenue, Fort Wayne, IN 46806 | 2011-10-07 |
| 1558645754 | Logan M Franke | Pharmacist | 222 E Pettit Ave, Fort Wayne, IN 46806 | 2011-10-06 |
| 1356513725 | Seazoned Med Transportation Service | Non-emergency Medical Transport (VAN) | 2809 Smith Street, Fort Wayne, IN 46806 | 2008-03-26 |
| 1376711267 | Hector F Perez Md PC | Family Medicine | 5717 So Anthony, Ste 500, Fort Wayne, IN 46806 | 2008-02-14 |
| 1174657480 | Robert Anthony Ford | Case Manager/Care Coordinator | 525 Oxford St., Fort Wayne, IN 46806 | 2007-03-16 |
| 1669622403 | Sally J Hartman | Nurse Practitioner | 2700 S Lafayette St, Suite 200, Fort Wayne, IN 46806-1100 | 2008-09-30 |
| 1003099441 | Lafayette Foot and Ankle Clinic | Podiatrist | 2700 Lafayette St Ste 230, Fort Wayne, IN 46806-1100 | 2007-12-07 |
| 1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
| 1053376186 | Rebecca Konkin | Nurse Practitioner | 2700 Lafayette St, Ste B-10, Fort Wayne, IN 46806-1100 | 2006-04-20 |
| 1316556848 | Alliance Health Centers, Inc. | Nurse Practitioner | 2700 Lafayette St, Fort Wayne, IN 46806-1100 | 2020-07-30 |
| Find all providers in zip 46806 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025037 | Emma Kathleen O'heeney | Dentist | 9405 Illinois Rd, Fort Wayne, IN 46804-5795 | 2019-07-24 |
| 1023670874 | Cory Kappesser | Dentist | 10505 Lima Rd, Fort Wayne, IN 46818-9536 | 2019-07-02 |
| 1558843698 | John Lawrence Bixler | Dentist | 7207 Engle Rd Ste 2, Fort Wayne, IN 46804-2231 | 2018-09-05 |
| 1366960445 | Chelsea L Schafer | Dentist | 2828 E State Blvd Ste A, Fort Wayne, IN 46805-4761 | 2017-09-08 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1740697945 | Vishali Sharma | Dentist | 4716 Illinois Rd, Fort Wayne, IN 46804-5122 | 2014-07-20 |
| 1306250642 | Jeffrey Max Batesole | Dentist | 9121 Illinois Rd, Fort Wayne, IN 46804-5753 | 2014-06-15 |
| 1891120382 | Salkeld Family Dental, LLC | Dentist | 12962 Coldwater Rd, Fort Wayne, IN 46845-9517 | 2013-09-04 |
| 1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
| 1467726851 | Gentle Care Family Dentistry | Dentist | 2444 Getz Rd, Fort Wayne, IN 46804-1632 | 2012-03-02 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46806 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.