OrganizationActive
Airway & Midface Development, LLC
NPI 1720777840 · Dental Clinic/Center · Granger, IN
Provider details
- NPI number
- 1720777840
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Nicole Rousculp, Director of Operations(574) 968-5166
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7221 N Fir Rd
Granger, IN 46530
Phone: (574) 968-5166
Fax: (877) 317-3186
Approximate (ZIP-level) locationGet directions
Mailing address
7221 N Fir Rd
Granger, IN 46530
Other names (DBA / former)
- Doing business as
- Tmj Amd
Registry dates
- Enumerated
- 2023-05-04
- Last updated
- 2023-05-04
- Certified
- 2023-05-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.