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INDIANA TMJ TREATMENT CENTER NPI 1912955832


NPI Information

NPI: 1912955832
Provider Name: INDIANA TMJ TREATMENT CENTER
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
210 EAST WATER STREET
PENDLETON, IN
ZIP 46064
Phone: (765) 778-3332
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INDIANA TMJ TREATMENT CENTER is a general practice dentist in Pendleton, IN. The provider is 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. INDIANA TMJ TREATMENT CENTER NPI is 1912955832. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

210 EAST WATER STREET
PENDLETON, IN
ZIP 46064-206
Phone: (765) 778-3332
Fax: (765) 778-4860

The provider's authorized official is Kenneth Lau .
The authorized official title is Doctor and has the following contact phone number (765) 778-3332.

The enumeration date for this NPI number is 5/4/2006 and was last updated on 5/20/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice7161INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000196290OTHERINDIANABLUE CROSS AND BLUE SHIEL
2=========-001MEDICARE UPININDIANA
3U21723MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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