1. Home
  2. Directory
  3. Indiana
  4. Kokomo
  5. Dentist
  6. NPI Profile

KOKOMO PEDIATRIC DENTISTRY, LLC
NPI 1063904100
Dentist - Dental Public Health in Kokomo, IN

Active since June 05, 2018
2350 S DIXON RD STE 425, KOKOMO, IN 46902(765) 453-6000 Get Directions Write a Review

NPPES record last updated: June 5, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kokomo Pediatric Dentistry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOKOMO PEDIATRIC DENTISTRY, LLC (NPI 1063904100) is a healthcare organization registered as a dental public health in Kokomo, Indiana and active in the NPI registry since June 2018. The organization lists Kevin Beadle, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1063904100
Entity TypeOrganization
Primary Taxonomy1223D0001X
Legal Business NameKOKOMO PEDIATRIC DENTISTRY, LLC
Location Address2350 S DIXON RD STE 425Kokomo, IN 46902-6422
Mailing Address1314 Regal DrCarmel, IN 46032-9489
Phone(765) 453-6000
Organization SubpartNo
Authorized OfficialKevin BeadleOwner/dentist · (317) 709-2318
Enumeration DateJune 5, 2018
✔ NPI 1063904100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Dental Public HealthDental Providers
Taxonomy Code1223D0001X
License✔ Licensed in IN · 12010865A
Definition
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.
2350 S DIXON RD STE 425, Kokomo, IN 46902
Open in Google Maps ↗

Other Identifiers 1

Medicaid200826740IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kokomo Pediatric Dentistry, LLC's NPI number?

The NPI number for Kokomo Pediatric Dentistry, LLC is 1063904100. It was assigned to this organization in the NPPES registry on June 5, 2018.

Where is Kokomo Pediatric Dentistry, LLC located?

Kokomo Pediatric Dentistry, LLC is located at 2350 S Dixon Rd Ste 425, Kokomo, IN 46902. The listed phone number is (765) 453-6000.

What is Kokomo Pediatric Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dental Public Health, with taxonomy code 1223D0001X.

What insurance does Kokomo Pediatric Dentistry, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and DentaQuest USA Insurance list Kokomo Pediatric Dentistry, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kokomo Pediatric Dentistry, LLC was last updated on June 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.