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South Bend Smiles Youth Dentistry, LLC

General Practice Dentistry in Mishawaka, IN · enumerated 2007 · authorized official Jenell Stump, Manager, Licensing & Credentialing.

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

National Provider Identifier

1902017593

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Registry record

Entity type Organization (Type 2)
Legal business name South Bend Smiles Youth Dentistry, LLC
Practice address 2332 Miracle Ln, Mishawaka, IN, 46545
Phone (574) 259-5437
Fax (574) 259-5438
Enumeration date May 24, 2007
Last updated in NPPES Jul 9, 2014

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers Primary

Authorized official

Name Jenell Stump
Title Manager, Licensing & Credentialing
Phone (615) 750-0343

Other identifiers

Identifier Type State Issuer
200828710A Medicaid IN -
1902017593 Medicaid MI -

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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-07-09. Verify at npiregistry.cms.hhs.gov.
Where is South Bend Smiles Youth Dentistry, LLC located?
The practice location on file with NPPES is in Mishawaka, IN.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-07-09.