PEDIATRIC DENTAL ASSOCIATES OF INDIANA, INC
NPI 1679661565
Dentist - Pediatric Dentistry in Highland, IN

Q: What is Pediatric Dental Associates Of Indiana, Inc's specialty?

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

Active since October 10, 2006

2100 45TH ST, HIGHLAND, IN 46322(219) 924-4411(219) 924-2314 Get Directions Write a Review

NPPES record last updated: September 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 1, 2022, Jun 24, 2020, Jan 29, 2020 and 2 more (5 updates tracked since 2019).

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About Pediatric Dental Associates Of Indiana, Inc NPPES

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

PEDIATRIC DENTAL ASSOCIATES OF INDIANA, INC (NPI 1679661565) is a healthcare organization registered as a pediatric dentistry in Highland, Indiana and active in the NPI registry since October 2006. The organization maintains a secondary practice location in Valparaiso and lists Carl Joseph Tyree, Owner, as its authorized official.

NPPES Registry Identity

NPI1679661565

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTAL ASSOCIATES OF INDIANA, INC

Location Address2100 45TH STHighland, IN 46322-3742

Mailing Address2100 45th StHighland, IN 46322-3742 · (219) 924-4411 · Fax (219) 924-2314

Phone(219) 924-4411

Fax(219) 924-2314

Organization SubpartNo

Authorized OfficialCarl Joseph TyreeOwner · (219) 924-4411

Enumeration DateOctober 10, 2006

Last NPPES UpdateSeptember 1, 20225 updates tracked since enumeration

NPPES CertifiedSeptember 1, 2022

✔ NPI 1679661565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

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.

2100 45TH ST, Highland, IN 46322

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Secondary Practice Location 1

Location 1800 Wall StValparaiso, IN 46383-2564 · Phone (219) 462-6337

Other Identifiers 1

Medicaid100208100IN

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

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

DR. CARL JOSEPH TYREE DDS

Dentist (Pediatric Dentistry)

2100 45TH ST
HIGHLAND, IN 46322

Lake County (219) 924-4411

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 Pediatric Dental Associates Of Indiana, Inc's NPI number?

The NPI number for Pediatric Dental Associates Of Indiana, Inc is 1679661565. It was assigned to this organization in the NPPES registry on October 10, 2006.

Where is Pediatric Dental Associates Of Indiana, Inc located?

Pediatric Dental Associates Of Indiana, Inc is located at 2100 45th St, Highland, IN 46322. The listed phone number is (219) 924-4411.

What is Pediatric Dental Associates Of Indiana, Inc'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 Pediatric Dental Associates Of Indiana, Inc was last updated on September 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.