Advanced Dental Group LLC
Clinic/Center, Dental in Crown Point, IN. Organization (NPI-2).
NPI number1497949044
StatusActive
Last updated in NPPESJun 19, 2008
Details
- NPI
- 1497949044
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Dental Group LLC
- Organization subpart
- No
- Enumeration date
- Aug 28, 2007
- Last updated
- Jun 19, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Advanced Dental Concepts Of Winfield (Doing Business As)
Practice location
10780 Randolph StCrown Point, IN 46307-7615
Phone 219-663-6579 · Fax 219-663-5085
Mailing address
10780 Randolph StCrown Point, IN 46307-7615
Phone 219-663-6579 · Fax 219-663-5085
Authorized official
Kim A Kessler
Partner
2196636579
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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