Jefferson Dental Center, Inc. is a renowned Dental office in South Bend, Indiana. It is located at 2628 E Jefferson Blvd, South Bend, IN and its contact number is 574-233-7266. The authorized person for Jefferson Dental Center, Inc. is Mr. Mont L. Annis
who is Secretary of the place and their contact number is 574-233-7266. The primary license number for Jefferson Dental Center, Inc. is 12009908 A (Dental) in Indiana.
Jefferson Dental Center, Inc. Office is a healthcare facility where dedicated dental team composed of licensed professionals, including dentists (DDS or DMD), dental hygienists, dental assistants, and administrative staff (manage appointments, billing, and patient records) provides preventive, diagnostic, and therapeutic oral health services like oral exams and X-rays, fillings, fluoride treatments, teeth cleanings, implants, crowns, bridges, tooth extractions, root canals, and cosmetic procedures such as teeth whitening, braces and veneers to patients through outpatient care.
Complete Profile:
Jefferson Dental Center, Inc. Office speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Jefferson Dental Center, Inc.
Specialization:
Dentistry
Address:
2628 E Jefferson Blvd, South Bend, Indiana, 46615-2724
Phone:
574-233-7266
Fax:
574-233-7560
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this Office are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Mont L. Annis
Position:
Secretary
Contact Number:
574-233-7266
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Jefferson Dental Center, Inc. Office are as mentioned below.
NPI Number:
1760762108
NPI Enumeration Date:
17 Aug, 2011
NPI Last Update On:
08 Jan, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jefferson Dental Center, Inc. are as mentioned below.
Specialization
License Number
State
Status
Dental
12009908 A
Indiana
Primary
Dental
12007912 A
Indiana
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the Office such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
100222700A
Medicaid
Indiana
200496100A
Medicaid
Indiana
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Jefferson Dental Center, Inc. 2628 E Jefferson Blvd, South Bend, Indiana
Zip:
46615-2724
Phone Number:
574-233-7266
Fax Number:
574-233-7560
Patients can reach Jefferson Dental Center, Inc. at 2628 E Jefferson Blvd, South Bend, Indiana or can call to book an appointment on 574-233-7266. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.