HEALTHY SMILES PORTAGE, LLC (NPI# 1306308515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306308515 |
| Entity Type | Organization |
| Organization Name | HEALTHY SMILES PORTAGE, LLC |
| Practice Address |
6280 W Main St Portage IN 46368-4670 |
| Mailing Address |
4629 Melton Rd Gary IN 46403-2866 |
| Practice Telephone | 2199382637 |
| Mailing Telephone | 2199382637 |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2019-04-05 |
| Authorized Official Name | NICHOLAS CAIN (OWNER) |
| Authorized Official Telephone | 2199382637 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
6280 W MAIN ST |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| 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 |
|---|---|---|---|---|
| 1225696248 | Christopher J Fronczak | Dentist | 8080 Moorsbridge Rd Ste 101, Portage, MI 49024-4422 | 2019-06-04 |
| 1093281149 | Secure Dental Vii | Dentist | 6129 Us Highway 6, Portage, IN 46368-5058 | 2018-10-16 |
| 1952821837 | Adalene Marie Chabon | Dentist | 8150 Moorsbridge Rd Ste A, Portage, MI 49024-7419 | 2017-06-22 |
| 1366848509 | Seubert Family Dentistry, LLC | Dentist | 260 W. Cook St., Portage, WI 53901-2106 | 2014-11-17 |
| 1265690044 | Joseph Michael Labella | Dentist | 1508 New Pinery Rd, Portage, WI 53901-1312 | 2008-05-28 |
| 1295930196 | Bewick Dental Corp | Dentist | 3410 Willowcreek Rd, Portage, IN 46368-5089 | 2007-06-19 |
| 1548462526 | Nicas Yiannias | Dentist | 5943 Central Ave, Portage, IN 46368-2946 | 2007-06-01 |
| 1164642906 | West Wind Family &cosmetic Denistry | Dentist | 1617 E Milham Ave, Portage, MI 49002-3049 | 2007-04-26 |
| 1699802280 | Frank Michael Walerko | Dentist | 6060 Lute Rd, Portage, IN 46368-5008 | 2007-02-28 |
| 1366579179 | Ronald H Flachs | Dentist | 4855 W Centre Ave, Portage, MI 49024-4686 | 2007-02-28 |
| Find all providers in PORTAGE | ||||
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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.