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JEFFERSON DENTAL CENTER, INC.
NPI 1760762108
Clinic/Center - Dental in South Bend, IN

Active since August 17, 2011
2628 E JEFFERSON BLVD, SOUTH BEND, IN 46615(574) 233-7266(574) 233-7560 Get Directions Write a Review

NPPES record last updated: January 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jefferson Dental Center, Inc. NPPES

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

JEFFERSON DENTAL CENTER, INC. (NPI 1760762108) is a healthcare organization registered as a dental in South Bend, Indiana and active in the NPI registry since August 2011. The organization lists Mont L. Annis, Secretary, as its authorized official.

NPPES Registry Identity

NPI1760762108
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameJEFFERSON DENTAL CENTER, INC.
Location Address2628 E JEFFERSON BLVDSouth Bend, IN 46615-2724
Mailing Address2628 E Jefferson BlvdSouth Bend, IN 46615-2724 · (574) 233-7266 · Fax (574) 233-7560
Phone(574) 233-7266
Fax(574) 233-7560
Organization SubpartNo
Authorized OfficialMont L. AnnisSecretary · (574) 233-7266
Enumeration DateAugust 17, 2011
Last NPPES UpdateJanuary 8, 2021
NPPES CertifiedJanuary 8, 2021
✔ NPI 1760762108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
Licenses✔ Licensed in IN · 12009908 A✔ Licensed in IN · 12007912 A
2628 E JEFFERSON BLVD, South Bend, IN 46615
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Other Identifiers 2

Medicaid100222700AIN
Medicaid200496100AIN

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.

DR. DANILO ALMEIDA DDS
Dentist
2628 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 233-7266
DR. LORRAINE JOSEPHINE CELIS D.D.S.
Dentist (General Practice)
2628 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 233-7266
DR. YICHING JEANNIE WU DDS
Dentist
2628 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 233-7266

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 Jefferson Dental Center, Inc.'s NPI number?

The NPI number for Jefferson Dental Center, Inc. is 1760762108. It was assigned to this organization in the NPPES registry on August 17, 2011.

Where is Jefferson Dental Center, Inc. located?

Jefferson Dental Center, Inc. is located at 2628 E Jefferson Blvd, South Bend, IN 46615. The listed phone number is (574) 233-7266.

What is Jefferson Dental Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Jefferson Dental Center, Inc. was last updated on January 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.