LIFETIME DENTAL CAREOF INDIANA, PC (NPI# 1891917282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891917282 |
| Entity Type | Organization |
| Organization Name | LIFETIME DENTAL CAREOF INDIANA, PC |
| Other Organization Name | SOUTH BEND FAMILY DENTAL CARE |
| Practice Address |
1605 North Ironwood South Bend IN 46635 |
| Practice Telephone | 5742719693 |
| Practice Fax Number | 5742719719 |
| Mailing Telephone | 5742719693 |
| Mailing Fax Number | 5742719719 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | AMY KROEGER (INS COOD) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| South Bend Family Dental Care | Doing Business As Name - Organization |
| Street Address |
1605 NORTH IRONWOOD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| 1932295532 | Keith Munneke | Social Worker | 17195 Cleveland Rd., South Bend, IN 46635 | 2006-10-04 |
| Find all providers in zip 46635 | ||||
| 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 |
|---|---|---|---|---|
| 1871116673 | Chelsea Ann Myers | Dentist | 206 W Ireland Rd, South Bend, IN 46614-2506 | 2020-05-27 |
| 1437644549 | Modupe Mary Ogunnusi Sofuye | Dentist | 1290 E Ireland Rd, South Bend, IN 46614-3474 | 2018-06-30 |
| 1508020066 | Gerald Warrell | Dentist | 2314 Miami St, South Bend, IN 46614-1336 | 2008-07-14 |
| 1619144672 | James Alvin Douglas | Dentist | 820 E Colfax Ave, South Bend, IN 46617-2804 | 2008-05-09 |
| 1962670208 | Paul Michael Mcleod | Dentist | 919 E Jefferson Blvd Ste Ll02, South Bend, IN 46617-3119 | 2008-02-20 |
| 1447428248 | Daniel Frederick Lindborg | Dentist | 52303 Emmons Road, Suite 17, South Bend, IN 46637-4294 | 2008-02-14 |
| 1275701369 | Geoffrey A. Klopenstine Dds PC | Dentist | 51584 Us Highway 33, South Bend, IN 46637-1704 | 2008-02-12 |
| 1659581007 | Philip Paul Hulecki | Dentist | 3608 Pleasant St, South Bend, IN 46615-2033 | 2007-05-23 |
| 1780704247 | Douglas John Kosek | Dentist | 413 W Jefferson Blvd, South Bend, IN 46601-1514 | 2007-03-29 |
| 1578695086 | Charles Wesley Magnuson | Dentist | 1331 Chimes Blvd, South Bend, IN 46615-3549 | 2007-03-10 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
Please comment or provide details below to improve the information on LIFETIME DENTAL CAREOF INDIANA, PC.
| 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.