CENTER GROVE DENTAL, LLC (NPI# 1881152585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881152585 |
| Entity Type | Organization |
| Organization Name | CENTER GROVE DENTAL, LLC |
| Practice Address |
4800 W Smith Valley Rd Ste K Greenwood IN 46142-9195 |
| Practice Telephone | 3178827800 |
| Practice Fax Number | 3178932986 |
| Mailing Telephone | 3178827800 |
| Mailing Fax Number | 3178932986 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |
| Authorized Official Name | DR. SUNG H KONG (OWNER) |
| Authorized Official Telephone | 3178827800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200533220 | 05 |
| Other Name | Type Code |
|---|---|
| Center Grove Dental | Doing Business As Name - Organization |
| Street Address |
4800 W SMITH VALLEY RD STE K |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46142-9195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093330979 | Renee Francine Jones | Nurse Practitioner | 698 Oldfield Commons Dr, Greenwood, IN 46142 | 2020-06-16 |
| 1164046876 | Top Dental Care LLC | Dentist | 41 N. Madison Ave, Greenwood, IN 46142 | 2020-05-29 |
| 1467956201 | Gerth Counseling | Social Worker | 386 Meridian Parke Lane, Suit B, Greenwood, IN 46142 | 2018-03-19 |
| 1588019988 | Jessica Lynn Osborne | Speech-Language Pathologist | 1701 Library Park Blvd, Greenwood, IN 46142 | 2016-05-04 |
| 1417301359 | John Thomas Ferguson Jr. | Marriage & Family Therapist | 3209 W Smith Valley Road, #225, Indianapolis, IN 46142 | 2016-04-18 |
| 1982065132 | Linda Barnes | Occupational Therapist | 124 Hawthorne Lane, Greenwood, IN 46142 | 2016-03-16 |
| 1346611688 | Elisha Cain | Optometrist | 1298 Us-31, Greenwood, IN 46142 | 2015-10-13 |
| 1801158456 | Frank William Fortuna | Family Medicine | 461 Camby Court, Greenwood, IN 46142 | 2012-06-11 |
| 1164708202 | Greenwood Family Chiropractic, LLC | Chiropractor | 520 N Sr 135, Suite R, Greenwood, IN 46142 | 2011-11-02 |
| 1447536586 | Leanne Nicole Schlueter | Chiropractor | 520 North Sr 135, Suite R, Greenwood, IN 46142 | 2011-11-02 |
| Find all providers in zip 46142 | ||||
| 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 |
|---|---|---|---|---|
| 1508483611 | Monica Vance | Dentist | 1711 S State Road 135 Ste B, Greenwood, IN 46143-6481 | 2020-07-06 |
| 1821650284 | Lindsay Kay Fuqua | Dentist | 1302 Sc-72 Business, Greenwood, SC 29649 | 2019-07-05 |
| 1184174815 | Dr. Subodh Gurung | Dentist | 506 Bypass 72 Nw, Greenwood, SC 29649-1300 | 2016-10-05 |
| 1376908160 | Jeffrey Golder D.d.s. P.C. | Dentist | 4800 W Smith Valley Rd, Ste K, Greenwood, IN 46142-9198 | 2015-12-21 |
| 1558742759 | Seema Pillai | Dentist | 704 S State Road 135 Ste A, Greenwood, IN 46143-6501 | 2015-06-12 |
| 1053710202 | Garrett Fiorenza | Dentist | 438 S Emerson Ave Ste 230, Greenwood, IN 46143-1948 | 2014-08-13 |
| 1962849117 | Jillian Helene Samela | Dentist | 1678 Fry Rd Ste B, Greenwood, IN 46142-1176 | 2013-05-29 |
| 1437408630 | Mark Allan Vorhies | Dentist | 1678 Fry Road, Suite A, Greenwood, IN 46142-1175 | 2012-09-04 |
| 1700172509 | Priya Patel | Dentist | 601 Library Park Dr Ste B-1, Greenwood, IN 46142-1562 | 2011-06-21 |
| 1497044127 | Dental Anesthesia of Indiana, LLC | Dentist | 924 Silver Valley Cir, Greenwood, IN 46142-9664 | 2011-04-04 |
| Find all providers in GREENWOOD | ||||
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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.