OrganizationActive
South Bend Smiles Youth Dentistry, LLC
NPI 1902017593 · General Practice Dentistry · Mishawaka, IN
Provider details
- NPI number
- 1902017593
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jenell Stump, Manager, Licensing & Credentialing(615) 750-0343
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
2332 Miracle Ln
Mishawaka, IN 46545-3012
Phone: (574) 259-5437
Fax: (574) 259-5438
Street-level locationGet directions
Mailing address
16 Arcade Unit 198747
Nashville, TN 37219-1994
Registry dates
- Enumerated
- 2007-05-24
- Last updated
- 2014-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.