Provider Demographics
NPI:1417749748
Name:ADVANCED DENTAL CONCEPTS LLC
Entity type:Organization
Organization Name:ADVANCED DENTAL CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:219-384-3636
Mailing Address - Street 1:10780 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7615
Mailing Address - Country:US
Mailing Address - Phone:219-663-6878
Mailing Address - Fax:
Practice Address - Street 1:10780 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7615
Practice Address - Country:US
Practice Address - Phone:219-663-6878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED DENTAL CONCEPTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty