IndividualActive
Shirley Bootz, LDH
NPI 1790444248 · Dental Hygienist · South Bend, IN
Provider details
- NPI number
- 1790444248
- Entity type
- Individual
- Primary specialty
- Dental HygienistDental Providers
- Credential
- LDH
- Sex
- Female
- Sole proprietor
- No
- License
- 13004216A (IN)
Specialties & taxonomies
Dental Providers
Practice location
220 Dean Johnson Blvd
South Bend, IN 46601-3415
Phone: (574) 289-7001
Fax: (574) 236-7166
Approximate (ZIP-level) locationGet directions
Mailing address
220 Dean Johnson Blvd
South Bend, IN 46601-3415
Registry dates
- Enumerated
- 2021-12-13
- Last updated
- 2021-12-13
- Certified
- 2021-12-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.