Summit Dental LLC
Dentist in Knox, IN. Organization (NPI-2).
NPI number1972882736
StatusActive
Last updated in NPPESAug 11, 2011
Details
- NPI
- 1972882736
- Entity type
- Organization (NPI-2)
- Legal business name
- Summit Dental LLC
- Organization subpart
- No
- Enumeration date
- Aug 11, 2011
- Last updated
- Aug 11, 2011
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 |
|---|---|---|---|---|
| 122300000X | Dentist | 12009766 | IN | Yes |
Practice location
1006 S Edgewood DrSuite A
Knox, IN 46534-8226
Phone 574-772-3541
Mailing address
1006 Edgewood DriveSuite A
Knox, IN 46534-8226
Phone 574-772-3541
Authorized official
Christopher Hulen
President
5747723541
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