HARRISON DENTAL, LLC (NPI# 1023432200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023432200 |
| Entity Type | Organization |
| Organization Name | HARRISON DENTAL, LLC |
| Other Organization Name | HARRISON DENTAL |
| Practice Address |
225 S Harrison St Shelbyville IN 46176-2159 |
| Practice Telephone | 3173980066 |
| Mailing Telephone | 3173980066 |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |
| Authorized Official Name | JEAN TUNGATE (OFFICE MANAGER) |
| Authorized Official Telephone | 3173980066 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
12009085A | IN | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
12011411A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | NPI TYPE 1 | 1487775144 | 01 |
| IN | DENTAL LICENSE | 12009085A | 01 |
| IN | NPI TYPE 1 | 1376687509 | 01 |
| IN | DENTAL LICENSE | 12011411A | 01 |
| Other Name | Type Code |
|---|---|
| Harrison Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619188711 | Harrison Dental, LLC | Dentist | 1800 S.w. 1rst Ave., Suite 530, Portland, OR 97201-5328 | 2007-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HARRISON DENTAL, LLC | 2000 Sw First Ave Ste 210, Portland, OR 97201 |
| Indiana Business Entities | HARRISON DENTAL, LLC | 225 S Harrison St, Shelbyville, IN 46176 |
| Street Address |
225 S HARRISON ST |
| City | SHELBYVILLE |
| State | IN |
| Zip Code | 46176-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376687509 | Darrin Ray Combs | Dentist | 225 S Harrison St, Shelbyville, IN 46176-2159 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043875180 | Usrc Mhp, LLC | Clinic/Center | 2460 Intelliplex Dr Ste 120, Shelbyville, IN 46176 | 2019-05-03 |
| 1679056899 | Debra Lynn Phillips | Counselor | 2434 E Sr 44, Shelbyville, IN 46176 | 2018-09-13 |
| 1083138762 | Megan Kari Battles | Specialist/Technologist | 3429 N 625 E, Shelbyville, IN 46176 | 2017-08-03 |
| 1336677046 | John Paul Bonvillian | Podiatrist | Major Hospital, 2451 Intelliplex Dr, Shelbyville, IN 46176 | 2017-05-24 |
| 1497202972 | Michael Neice | Non-emergency Medical Transport (VAN) | 4427 N Billman Estate, Shelbyville, IN 46176 | 2016-09-01 |
| 1972869923 | Joseph Moheban | General Practice | 1120 Spring Hill Dr., Shelbyville, IN 46176 | 2012-04-04 |
| 1548595440 | Patrick A Wagner Phd PC | Psychologist | 1253 North Deer Run E Drive, Shelbyville, IN 46176 | 2009-10-09 |
| 1740475326 | Assisted Living Concepts Inc | Assisted Living Facility | 2216 North Riley Highway, Shelbyville, IN 46176 | 2007-09-07 |
| 1073734711 | Katherine M Leugers | Counselor | 7 E Hendricks Street, Shelbyville, IN 46176 | 2007-05-01 |
| 1649394479 | Kay Lynne Zietlow | Pharmacist | 1412 Miller Avenue, Shelbyville, IN 46176 | 2007-03-19 |
| Find all providers in zip 46176 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524477 | Katherine E. Ferry | Dentist | 4303 E Windsor Ln, Columbus, IN 47201-4022 | 2020-10-08 |
| 1609421965 | Hawra Alqallaf | Dentist | 1121 W Michigan St # Ds422, Indianapolis, IN 46202-5211 | 2019-08-05 |
| 1952814238 | Center for Implant Denistry and Periodontics, LLC | Dentist | 9885 E 116th St Ste 300, Fishers, IN 46037-9242 | 2017-11-09 |
| 1518470897 | Meridian Street Periodontics, LLC | Dentist | 8801 N Meridian St Ste 103, Indianapolis, IN 46260-2353 | 2017-11-09 |
| 1538410451 | Eon Clinics Indiana LLC | Dentist | 10020 Calumet Ave, Munster, IN 46321-4055 | 2012-10-02 |
| 1164726832 | Indy East Periodontics PC | Dentist | 115 N Shortridge Rd Ste 100, Indianapolis, IN 46219-4917 | 2011-01-10 |
| 1588997183 | Shane T Cope Dds, PC | Dentist | 10435 Commerce Drive, Suite 120, Carmel, IN 46032 | 2009-09-14 |
| 1366697070 | Bruce B. Wiland, Dds, Msd | Dentist | 3415 S Lafountain St Ste K, Kokomo, IN 46902-3827 | 2008-11-21 |
| 1023267770 | James M. Humphrey | Dentist | 221 S. 19th Street, Terre Haute, IN 47807-4129 | 2008-09-17 |
| 1891968194 | James Kirk | Dentist | 500 W Lincoln Hwy Ste N, Merrillville, IN 46410 | 2008-04-08 |
| Find all providers with the same taxonomy | ||||
| City | SHELBYVILLE |
| Zip Code | 46176 |
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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.