HOOSIER DENTURES & DENTAL SURGERY, LLC (NPI# 1609002724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609002724 |
| Entity Type | Organization |
| Organization Name | HOOSIER DENTURES & DENTAL SURGERY, LLC |
| Practice Address |
1200 S Peru St Cicero IN 46034-9161 |
| Practice Telephone | 3178097790 |
| Mailing Telephone | 3178097790 |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2009-06-03 |
| Authorized Official Name | DR. SCOTT THOLE (OWNER) |
| Authorized Official Telephone | 3178097790 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
12010014 | IN | Ambulatory Health Care Facilities |
| Street Address |
1200 S PERU ST |
| City | CICERO |
| State | IN |
| Zip Code | 46034-9161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548486905 | Mark R Montgomery | Dentist | 130 W Jackson St, Cicero, IN 46034 | 2007-04-17 |
| 1689710170 | Thomas Jerry Elliott Sr. | Dentist | 17 West Jackson St., Cicero, IN 46034 | 2007-01-30 |
| 1144285719 | Mary Angela Shirley | Social Worker | 209 S Peru St, Ste 210-211, Cicero, IN 46034 | 2006-04-18 |
| 1164486601 | Nancy Leah Shirley | Social Worker | 209 S Peru Street, Suite 210 211, Cicero, IN 46034 | 2006-04-13 |
| 1700867827 | Richard Edward Hayes | Family Medicine | 1160 S. Peru Street, S.r. 19, Cicero, IN 46034 | 2005-11-07 |
| 1306251897 | Jon Purkey | Specialist/Technologist | 230 Washington Avenue, Cicero, IN 46034-0321 | 2014-06-24 |
| 1477836070 | Myrtie B Mays | Specialist | 22345 Schulley Rd, Cicero, IN 46034-8800 | 2011-09-21 |
| 1710549142 | Julie Baber | Technician | 1180 Coral Springs Dr, Cicero, IN 46034-9214 | 2019-07-05 |
| 1669592572 | Shelley Kunkel | Developmental Therapist | 1215 Coral Springs Dr, Cicero, IN 46034-9217 | 2007-04-02 |
| 1467572297 | Allison Labrie | Specialist | 1010 W Morse Dr, Cicero, IN 46034-9238 | 2007-03-29 |
| Find all providers in zip 46034 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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|---|---|---|---|---|
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| 1487195418 | Cicero Family Dental Care | Clinic/Center | 8382 Elta Dr, Cicero, NY 13039-8905 | 2017-03-09 |
| 1063685196 | Dental Shine, Ltd | Clinic/Center | 2319 S Cicero Ave, Cicero, IL 60804-2451 | 2008-04-09 |
| 1467920686 | Vdc Cicero Corp | Clinic/Center | 3320 S Cicero Ave, Cicero, IL 60804-4531 | 2018-11-06 |
| 1881169134 | Braces Town PC | Clinic/Center | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2018-10-12 |
| 1326537887 | Reginald Woo Dmd Ltd. | Clinic/Center | 5315 W Cermak Rd, Cicero, IL 60804-2817 | 2018-05-09 |
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| 1508471814 | White River Family Dental and Implant Center | Clinic/Center | 1638 W Smith Valley Rd Ste B, Greenwood, IN 46142-1550 | 2020-09-14 |
| 1669087144 | Babb Dentistry LLC | Clinic/Center | 2229 W Virginia St, Evansville, IN 47712-5214 | 2020-09-11 |
| 1790398451 | Bryant P. Burkett Dds, LLC | Clinic/Center | 5310 Pearl Dr Ste C, Evansville, IN 47712-8105 | 2020-08-24 |
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1831701044 | Tree of Life LLC | Clinic/Center | 311 Florence Ave, Granger, IN 46530-8049 | 2020-08-19 |
| 1568073096 | Fdg Mobile | Clinic/Center | 438 S Emerson Ave Ste 231, Greenwood, IN 46143-1948 | 2020-08-10 |
| 1992315980 | Kaszuba Dental, LLC | Clinic/Center | 1934 45th St, Munster, IN 46321-3917 | 2020-08-04 |
| 1205454014 | Advanced Dental Care of Fortville, LLC | Clinic/Center | 545 Vitality Dr Ste F, Fortville, IN 46040-1373 | 2020-07-08 |
| 1366066375 | Jindal Management LLC | Clinic/Center | 701 N Weinbach Ave Ste 910, Evansville, IN 47711-6607 | 2020-06-05 |
| Find all providers with the same taxonomy | ||||
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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.