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SHOCK KOKOMO, LLC
NPI 1528780418
Clinic/Center - Dental in Kokomo, IN

Active since September 16, 2022
310 E ALTO RD, KOKOMO, IN 46902(765) 864-2328 Get Directions Write a Review

NPPES record last updated: September 16, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Other Providers Same Location
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Dental

About SHOCK KOKOMO, LLC

This page provides the complete NPI Profile along with additional information for Shock Kokomo, Llc, a provider established in Kokomo, Indiana operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1528780418 assigned on September 2022. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Liz Shock (Practice Administrator)

NPI
1528780418 Verify this NPI
Provider Name
SHOCK KOKOMO, LLC
Entity Type
Organization
Location Address
310 E ALTO RD KOKOMO, IN 46902
Location Phone
(765) 864-2328
Mailing Address
15437 STAFFORDSHIRE WAY FISHERS, IN 46037
Mailing Phone
(317) 450-5797
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-16-2022
Last Update Date
09-16-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LIZ SHOCK

Authorized Official Title
PRACTICE ADMINISTRATOR
Authorized Official Phone
(317) 450-5797

Reviews for SHOCK KOKOMO, LLC

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

KYLE DAVIS
Dentist (General Practice)
310 E ALTO RD
KOKOMO, IN 46902
Howard County (765) 864-2328

Frequently Asked Questions

What is SHOCK KOKOMO, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1528780418, enumerated as an "organization" on September 16, 2022.

Where is the provider located?

The provider is located at 310 E ALTO RD KOKOMO, IN 46902 and the phone number is (765) 864-2328.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.