KOKOMO IMPLANT AND ORAL SURGERY, LLC (NPI# 1992159552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992159552 |
Entity Type | Organization |
Organization Name | KOKOMO IMPLANT AND ORAL SURGERY, LLC |
Practice Address |
2008 West Sycamore Street Kokomo IN 46901-4112 |
Mailing Address |
9860 Westpoint Drive Suite 100 Indianapolis IN 46256-3398 |
Practice Telephone | 7954520033 |
Practice Fax Number | 7654572175 |
Mailing Telephone | 3178411100 |
Mailing Fax Number | 3178412200 |
Enumeration Date | 2016-04-20 |
Last Update Date | 2016-04-20 |
Authorized Official Name | MRS. WENDY S. BEARD (OFFICE MANAGER) |
Authorized Official Telephone | 3178411100 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12012362A | IN | Dental Providers |
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12007255A | IN | Dental Providers |
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12010961A | IN | Dental Providers |
Street Address |
2008 WEST SYCAMORE STREET |
City | KOKOMO |
State | IN |
Zip Code | 46901-4112 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
1255782306 | Forefront Dermatology, S.c. | Dermatology | 2130 W Sycamore St Ste 200, Kokomo, IN 46901 | 2016-06-29 |
1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
Find all providers in zip 46901 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346452448 | Heartland Dental Care of Indiana, PC | Dentist | 2016 S Elizabeth St, Kokomo, IN 46902 | 2007-05-03 |
1134245459 | Gerald Edward Kerr | Dentist | 2008 W Sycamore St, Kokomo, IN 46901-4112 | 2007-03-21 |
1922189273 | Charlie Cox Jr. | Dentist | 1970 W Boulevard, Kokomo, IN 46902-6078 | 2006-10-17 |
1780833194 | Hcoms, PC | Dentist | 1970 W Boulevard, Kokomo, IN 46902-6078 | 2008-09-10 |
1679786487 | Ferdinand Wesley Peik | Dentist | 3421 S Lafountain St, Kokomo, IN 46902-3852 | 2007-05-08 |
1588723530 | Ronald A. Thompson Jr. | Dentist | 2705 S Berkley Rd, Suite 4d, Kokomo, IN 46902-8025 | 2006-12-06 |
1164503140 | Howard County Oral and Maxillofacial Surgeons | Dentist | 1970 W Boulevard, Kokomo, IN 46902-6078 | 2006-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063918746 | Robinpreet Singh Pannu | Dentist | 550 University Blvd Ste 3195, Indianapolis, IN 46202-5149 | 2018-04-02 |
1912435843 | Advanced Family Dentistry | Dentist | 9845 E 116th St Ste 400, Fishers, IN 46037-9236 | 2017-05-23 |
1093250151 | Ruckman Oral Surgery and Implant Center LLC | Dentist | 9901 Auburn Rd, Fort Wayne, IN 46825-2345 | 2016-12-28 |
1659752335 | Yusif Umar | Dentist | 550 University Blvd # Uh3145, Indianapolis, IN 46202-5149 | 2015-06-17 |
1154710267 | Lawrence G. Falender Dds PC | Dentist | 1320 N Post Rd, Indianapolis, IN 46219-4210 | 2015-01-13 |
1568878270 | Austin Starr | Dentist | 473 S Landmark Ave, Bloomington, IN 47403-5005 | 2014-07-02 |
1144668989 | Timothy William Surber | Dentist | 5701 Brownstone Dr, Indianapolis, IN 46220-5851 | 2013-06-13 |
1396189387 | Intp Dental PC | Dentist | 8555 River Rd Ste 180, Indianapolis, IN 46240-4311 | 2013-04-22 |
1932440054 | John Joseph Schier Jr. | Dentist | 3021 E 98th St Ste 250, Indianapolis, IN 46280-2908 | 2013-03-14 |
1962766444 | Denise A Flanagan Dds PC | Dentist | 8240 Naab Rd Ste 355, Indianapolis, IN 46260-1987 | 2012-06-28 |
Find all providers with the same taxonomy |
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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.