HERITAGE FAMILY DENTAL (NPI# 1154693752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154693752 |
| Entity Type | Organization |
| Organization Name | HERITAGE FAMILY DENTAL |
| Practice Address |
731 N Green River Rd Evansville IN 47715-2415 |
| Practice Telephone | 8124763002 |
| Practice Fax Number | 8124763027 |
| Mailing Telephone | 8124763002 |
| Mailing Fax Number | 8124763027 |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |
| Authorized Official Name | NISSA MCCONNELL (OWNER/DENTIST) |
| Authorized Official Telephone | 8124763002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12011723A | IN | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HERITAGE FAMILY DENTAL | 27 W 17th Ave, Eugene, OR 97401 |
| Connecticut Business Registrations | HERITAGE FAMILY DENTAL, LLC | 410 Saybrook Rd, Suite -202, Middletown, CT 06457 |
| Indiana Business Entities | HERITAGE FAMILY DENTAL, P.C. | 10717 Havenwood Meadows Drive, Evansville, IN 47725 |
| Street Address |
731 N GREEN RIVER RD |
| City | EVANSVILLE |
| State | IN |
| Zip Code | 47715-2415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619141983 | Nissa N Mcconnell | Dentist | 731 N Green River Rd, Evansville, IN 47715-2415 | 2008-04-17 |
| 1437312634 | Paul James Mc Connell | Dentist | 731 N Green River Rd, Evansville, IN 47715-2415 | 2008-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528585 | Shannon Allcron | Pharmacist | 6770 E. Virginia St., Evansville, IN 47715 | 2020-11-03 |
| 1609339910 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1201 Cross Pointe Place, Evansville, IN 47715 | 2019-04-12 |
| 1497229223 | Hubert Family Dentistry LLP | Dentist | 6225 E Columbia St., Evansville, IN 47715 | 2019-01-15 |
| 1083110373 | Fyi Healthcare, LLC | Registered Nurse | 12000 Highway 41 North, Evansville, IN 47715 | 2018-04-04 |
| 1962862755 | New Journeys Counseling Services, LLC | Community/Behavioral Health | 4929 River Wind Pointe Drive, Evansville, IN 47715 | 2016-03-07 |
| 1558702456 | Jennifer Hoelter | Pharmacist | 5000 E Virginia St, Walgreens District Office, Evansville, IN 47715 | 2013-07-09 |
| 1952649402 | Courtney Ingold | Music Therapist | 621 E Cullen Ave, Suite 118, Evansville, IN 47715 | 2013-01-17 |
| 1922378041 | Sherry A. Fisher | Counselor | 4929 Riverwind Pointe Dr Ste 102, Evansville, IN 47715 | 2012-01-05 |
| 1710275912 | Tonja Leana Winekauf | Nurse Practitioner | 6211 E Waterford Blvd, Evansville Health Care Center, Evansville, IN 47715 | 2011-07-21 |
| 1003083437 | Allcare Dental & Dentures of In PC | Dentist | 1031 N. Green River Rd., Suite 104, Evansville, IN 47715 | 2008-05-14 |
| Find all providers in zip 47715 | ||||
| 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 |
|---|---|---|---|---|
| 1578181194 | Trisha Johnson Cahill | Dentist | 1202 W Buena Vista Rd Ste 206, Evansville, IN 47710-5134 | 2020-07-09 |
| 1497229223 | Hubert Family Dentistry LLP | Dentist | 6225 E Columbia St., Evansville, IN 47715 | 2019-01-15 |
| 1336661628 | Familia Dental Evansville LLC | Dentist | 804 S Green River Rd Ste A, Evansville, IN 47715-4106 | 2017-07-09 |
| 1548782956 | Michelle Donna Kelley | Dentist | 3700 Bellemeade Ave Ste 122, Evansville, IN 47714-0106 | 2017-07-07 |
| 1578913075 | Paul Effinger | Dentist | 961 S Kenmore Dr, Evansville, IN 47714-7514 | 2016-06-15 |
| 1255708723 | Peter Wulff | Dentist | 350 W Columbia St Ste 1-d, Evansville, IN 47710 | 2015-08-31 |
| 1104236769 | Raymond A. Crisio, D.m.d. PC | Dentist | 305 Broad, Evansville, IL 62242-0019 | 2014-05-05 |
| 1710271127 | Emaun Niknafs | Dentist | 5020 W Lloyd Expy Ste 200, Evansville, IN 47712-6580 | 2011-06-02 |
| 1285945550 | Jessica Hancock Renaker | Dentist | 508 N Green River Rd, Evansville, IN 47715-2412 | 2010-07-01 |
| 1609009661 | Anna Fedak Botts | Dentist | 449 S 1st St, Evansville, WI 53536-1394 | 2009-08-25 |
| Find all providers in EVANSVILLE | ||||
| City | EVANSVILLE |
| Zip Code | 47715 |
Please comment or provide details below to improve the information on HERITAGE FAMILY DENTAL.
| 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.