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SOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC
NPI 1356634471
Dentist - Pediatric Dentistry in Bloomington, IN

Active since May 23, 2011
828 S AUTO MALL RD, BLOOMINGTON, IN 47401(812) 333-5437(812) 333-6305 Get Directions Write a Review

NPPES record last updated: November 22, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southern Indiana Pediatric Dentistry, Llc NPPES

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

SOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC (NPI 1356634471), doing business as Rasche Pediatric Dentistry, Llc, is a healthcare organization registered as a pediatric dentistry in Bloomington, Indiana and active in the NPI registry since May 2011. The organization lists Matthew L Rasche, Owner/member, as its authorized official.

NPPES Registry Identity

NPI1356634471
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameSOUTHERN INDIANA PEDIATRIC DENTISTRY, LLC
Location Address828 S AUTO MALL RDBloomington, IN 47401-5430
Mailing Address828 S Auto Mall RdBloomington, IN 47401-5430 · (812) 333-5437 · Fax (812) 333-6305
Phone(812) 333-5437
Fax(812) 333-6305
Organization SubpartNo
Authorized OfficialMatthew L RascheOwner/member · (812) 661-0612
Enumeration DateMay 23, 2011
Last NPPES UpdateNovember 22, 2011
✔ NPI 1356634471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in IN · 12011284A
Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

828 S AUTO MALL RD, Bloomington, IN 47401
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Other Names 1

Former Legal Business NameRasche Pediatric Dentistry, Llc

Other Identifiers 1

Medicaid201019080IN

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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

J KEITH ROBERTS DDS LLC
Dentist (Pediatric Dentistry)
828 S AUTO MALL RD
BLOOMINGTON, IN 47401
Monroe County (812) 333-5437
MATTHEW LAWRENCE RASCHE D.D.S. M.S.D.
Dentist (Pediatric Dentistry)
828 S AUTO MALL RD
BLOOMINGTON, IN 47401
Monroe County (812) 333-5437

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 Southern Indiana Pediatric Dentistry, LLC's NPI number?

The NPI number for Southern Indiana Pediatric Dentistry, LLC is 1356634471. It was assigned to this organization in the NPPES registry on May 23, 2011. The provider was formerly known as Rasche Pediatric Dentistry, LLC.

Where is Southern Indiana Pediatric Dentistry, LLC located?

Southern Indiana Pediatric Dentistry, LLC is located at 828 S Auto Mall Rd, Bloomington, IN 47401. The listed phone number is (812) 333-5437.

What is Southern Indiana Pediatric Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Southern Indiana Pediatric Dentistry, LLC was last updated on November 22, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.