Center Grove Dental, Llc

LBN: Center Grove Dental, Llc
Center Grove Dental, Llc is an health care organization with primary practice located at 4800 W Smith Valley Rd Ste K , Greenwood IN 46142-9195. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Center Grove Dental, Llc can be contacted via phone (317) 882-7800, or through Kong, Sung H via phone (317) 882-7800.

Contact Information

Primary practice address
4800 W Smith Valley Rd Ste K Greenwood IN 46142-9195
Phone: (317) 882-7800
Fax: (317) 893-2986
Website:
Map and Directions
Authorized official contact:
Name: Kong, Sung H Doctor of Dental Surgery (DDS)
Phone: (317) 882-7800

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X

Profile Details

NPI number 1881152585
LBN Legal business name Center Grove Dental, Llc
DBA Doing business as
Authorized official Kong, Sung H Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 12th, 2019
Last updated Mar 12th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881152585 NPPES
Indiana MEDICAID 200533220

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