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Jefferson Dental Center, Inc.

Dental Clinic/Center in South Bend, IN · enumerated 2011 · authorized official Mont Annis, Secretary.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1760762108

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Registry record

Entity type Organization (Type 2)
Legal business name Jefferson Dental Center, Inc.
Practice address 2628 E Jefferson Blvd, South Bend, IN, 46615
Phone (574) 233-7266
Fax (574) 233-7560
Enumeration date Aug 17, 2011
Last updated in NPPES Jan 8, 2021

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities · License 12009908 A (IN) Primary
261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities · License 12007912 A (IN) Secondary

Authorized official

Name Mont Annis
Title Secretary
Phone (574) 233-7266

Other identifiers

Identifier Type State Issuer
100222700A Medicaid IN -
200496100A Medicaid IN -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Jefferson Dental Center, Inc.?
The NPI for Jefferson Dental Center, Inc. is 1760762108, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Jefferson Dental Center, Inc.?
NPPES lists Mont Annis (Secretary) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-01-08.