JP DENTAL - BLOOMINGTON, LLC (NPI# 1497160204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497160204 |
| Entity Type | Organization |
| Organization Name | JP DENTAL - BLOOMINGTON, LLC |
| Other Organization Name | CAMPUS FAMILY DENTAL |
| Practice Address |
409 S Dunn St Bloomington IN 47401-4822 |
| Practice Telephone | 8123396272 |
| Mailing Telephone | 8123396272 |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |
| Authorized Official Name | DR. JOHN PASICZNYK (MANAGER) |
| Authorized Official Telephone | 3309905055 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12011425A | IN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Campus Family Dental | Doing Business As Name - Organization |
| Street Address |
409 S DUNN ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47401-4822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267423 | H&b II LLC | Clinic/Center | 409 S Dunn St, Bloomington, IN 47401-4822 | 2017-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
| 1285116657 | Kimberly D Bergan | Occupational Therapist | 3607 S Heirloom Dr, Bloomington, IN 47401 | 2018-09-03 |
| 1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
| 1881104289 | Ev Bloomington Limited Partnership | Assisted Living Facility | 3607 South Heirloom Drive, Bloomington, IN 47401 | 2017-10-11 |
| 1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
| 1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
| 1194127381 | Ann Marie Neeley | Lactation Consultant, Non-RN | 2458 South Walnut Street, Bloomington, IN 47401 | 2014-09-19 |
| 1518397801 | Indiana Spine and Sports Inc. | Chiropractor | 418 S Walnut St Suite C, Bloomington, IN 47401 | 2013-11-22 |
| 1053654574 | William Robblee Anderson | Obstetrics & Gynecology | 2625 E. Spicewood Ct., Bloomington, IN 47401 | 2013-04-03 |
| 1285979377 | Jenna Marie Dale | Optometrist | 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 | 2012-11-30 |
| Find all providers in zip 47401 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972162527 | Pournawattie Andrea Chandradatt | Dentist | 7936 Portland Ave S, Bloomington, MN 55420-1315 | 2019-06-07 |
| 1336601756 | Neha Shah | Dentist | 17644 Valley Blvd Ste 1, Bloomington, CA 92316-3908 | 2019-04-03 |
| 1033689054 | Erick Esmenjaud D.d.s. Inc | Dentist | 18793 Valley Blvd Ste A-b, Bloomington, CA 92316-2253 | 2018-12-03 |
| 1336620160 | Mohamed Owais Sultan | Dentist | 857 S Auto Mall Rd Ste 4, Bloomington, IN 47401-5488 | 2018-08-29 |
| 1285184259 | Children's Center for Dentistry | Dentist | 2111 E Oakland Ave Ste C, Bloomington, IL 61701-5783 | 2016-10-13 |
| 1255783320 | Fatima Quadri | Dentist | 401 N Veterans Pkwy, Unit D, Bloomington, IL 61704-3550 | 2016-07-12 |
| 1528419686 | Brandt Allen Finney | Dentist | 2909 E Buick Cadillac Blvd, Bloomington, IN 47401-5443 | 2016-06-29 |
| 1942668702 | Point Family Dentistry | Dentist | 10611 France Ave S Ste 201, Bloomington, MN 55431-3554 | 2016-02-08 |
| 1710344494 | Bloomington Smiles Dentistry, PC | Dentist | 10700 France Avenue, Suite 102, Bloomington, MN 55437 | 2016-01-26 |
| 1518380070 | Cottage Dental Care LLC | Dentist | 2206 Cottage Ave, Bloomington, IL 61701-1447 | 2014-02-03 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47401 |
Please comment or provide details below to improve the information on JP DENTAL - BLOOMINGTON, LLC.
| 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.