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PLYMOUTH 20/20 DENTAL, LLC
NPI 1689122491
Dentist - General Practice in Plymouth, IN

Active since September 21, 2016
1409 N MICHIGAN ST, PLYMOUTH, IN 46563(574) 936-8787 Get Directions Write a Review

NPPES record last updated: September 21, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Plymouth 20/20 Dental, Llc NPPES

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

PLYMOUTH 20/20 DENTAL, LLC (NPI 1689122491) is a healthcare organization registered as a general practice in Plymouth, Indiana and active in the NPI registry since September 2016. The organization lists Ronald I Prokes, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1689122491
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePLYMOUTH 20/20 DENTAL, LLC
Location Address1409 N MICHIGAN STPlymouth, IN 46563-1119
Mailing Address1409 N Michigan StPlymouth, IN 46563-1119 · (574) 936-8787
Phone(574) 936-8787
Organization SubpartYesParent: 20/20 Dental, Llc
Authorized OfficialRonald I ProkesChief Financial Officer · (317) 601-6010
Enumeration DateSeptember 21, 2016
✔ NPI 1689122491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1409 N MICHIGAN ST, Plymouth, IN 46563
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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 3

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

PLYMOUTH FAMILY DENTAL CARE
Dentist (General Practice)
1409 N MICHIGAN ST
PLYMOUTH, IN 46563
Marshall County (574) 936-8787
FAMILY DENTAL CARE, CHAD SHAW D.D.S.,P.C.
Dentist (General Practice)
1409 N MICHIGAN ST
PLYMOUTH, IN 46563
Marshall County (574) 936-8787
JAMES RYAN DDS
Dentist
1409 N MICHIGAN ST
PLYMOUTH, IN 46563
Marshall County (574) 936-8787

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 Plymouth 20/20 Dental, LLC's NPI number?

The NPI number for Plymouth 20/20 Dental, LLC is 1689122491. It was assigned to this organization in the NPPES registry on September 21, 2016.

Where is Plymouth 20/20 Dental, LLC located?

Plymouth 20/20 Dental, LLC is located at 1409 N Michigan St, Plymouth, IN 46563. The listed phone number is (574) 936-8787.

What is Plymouth 20/20 Dental, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Plymouth 20/20 Dental, LLC was last updated on September 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.