National Provider Identifier Database

KOKOMO PEDIATRIC DENTISTRY LLC
Dental Public Health

The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.


Contact Information

KOKOMO PEDIATRIC DENTISTRY, LLC
2350 S DIXON RD STE 425
KOKOMO, IN46902-6422
Phone: 765-453-6000
Fax:
Website:
Specialty Taxonomy Code
* Dental Public Health 1223D0001X

* Indicates primary specialty

NPI Profile & details for KOKOMO PEDIATRIC DENTISTRY, LLC

NPI Number 1063904100
Legal business name
LBN
KOKOMO PEDIATRIC DENTISTRY, LLC
Authorized official KEVIN BEADLE - (OWNER/DENTIST)
Entity Organization
Organization subpart No
Enumeration date 06/05/2018
Last updated 06/05/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • IN License #: 12010865A
  • IN Medicaid: 200826740

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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