South Shore Smiles Llc

LBN: South Shore Smiles Llc
South Shore Smiles Llc is an health care organization with primary practice located at 9270 Wicker Ave Suite E And F, Saint John IN 46373-8508. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / General Practice is the primary health care specialty. South Shore Smiles Llc can be contacted via phone (219) 627-3133, or through Shieh, Roger K via phone (219) 716-1259.

Contact Information

Primary practice address
9270 Wicker Ave Suite E And F Saint John IN 46373-8508
Fax:
Website:
Authorized official contact:
Name: Shieh, Roger K Doctor of Dental Surgery (DDS)

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12011455A Indiana
Dental Providers / Pediatric Dentistry 1223P0221X 12011456A Indiana

Profile Details

NPI number 1356898050
LBN Legal business name South Shore Smiles Llc
DBA Doing business as
Authorized official Shieh, Roger K Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 9th, 2016
Last updated Sep 9th, 2016 - about 10 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 1356898050 NPPES
Indiana MEDICAID 1144540980
Indiana MEDICAID 1184944159

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