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MISHAWAKA DENTAL LLC
NPI 1730624529
Dentist in Mishawaka, IN

Active since January 03, 2017
4170 GRAPE RD, MISHAWAKA, IN 46545(574) 272-4200 Get Directions Write a Review

NPPES record last updated: January 3, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mishawaka Dental Llc NPPES

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

MISHAWAKA DENTAL LLC (NPI 1730624529) is a healthcare organization registered as a dentist in Mishawaka, Indiana and active in the NPI registry since January 2017. The organization lists Heather Kraushaar, Psr, as its authorized official.

NPPES Registry Identity

NPI1730624529
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameMISHAWAKA DENTAL LLC
Location Address4170 GRAPE RDMishawaka, IN 46545-2610
Mailing AddressPo Box 3189Syracuse, NY 13220-3189
Phone(574) 272-4200
Organization SubpartNo
Authorized OfficialHeather KraushaarPsr · (315) 454-6000
Enumeration DateJanuary 3, 2017
✔ NPI 1730624529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IN · 12012619A
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
4170 GRAPE RD, Mishawaka, IN 46545
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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

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.Insurance ›

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.

ADONI DENTAL PC
Dentist (General Practice)
4170 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 272-4200
TARNIT SINGH KAPOOR
Dentist
4170 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 272-4200
DR. KELLY CATHRYN TERRANOVA DDS
Dentist (General Practice)
4170 GRAPE RD
MISHAWAKA, IN 46545
St. Joseph County (574) 272-4200

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 Mishawaka Dental LLC's NPI number?

The NPI number for Mishawaka Dental LLC is 1730624529. It was assigned to this organization in the NPPES registry on January 3, 2017.

Where is Mishawaka Dental LLC located?

Mishawaka Dental LLC is located at 4170 Grape Rd, Mishawaka, IN 46545. The listed phone number is (574) 272-4200.

What is Mishawaka Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Mishawaka Dental LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Mishawaka Dental 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 Mishawaka Dental LLC was last updated on January 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.