Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jefferson Dental Center, Inc

Organization Dental Clinic/Center · NPI 1760762108

Jefferson Dental Center, Inc is a Dental Clinic/Center in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2011.

Licensed in
IN
In the registry since
2011
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2628 E Jefferson Blvd
South Bend, IN 46615-2724
Phone: (574) 233-7266
Fax: (574) 233-7560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 12009908 A (IN)
Dental Clinic/Center Taxonomy 261QD0000X · Licence 12007912 A (IN)

Record details

NPI number1760762108
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mont Annis — Secretary · (574) 233-7266
NPI enumeratedAugust 17, 2011
Last updated in NPPESJanuary 8, 2021
Certification dateJanuary 8, 2021
Mailing address2628 E Jefferson Blvd, South Bend, IN 46615-2724

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