OrganizationActive
Periodontal Associates of South Bend
NPI 1962078642 · Periodontics · South Bend, IN
Provider details
- NPI number
- 1962078642
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Gloria Royer, Practice Manager(765) 447-9319
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
1918 Edison Rd
South Bend, IN 46617-1711
Phone: (574) 287-8900
Street-level locationGet directions
Mailing address
1918 Edison Rd
South Bend, IN 46617-1711
Other names (DBA / former)
- Doing business as
- Periodontal Associates of South Bend
Registry dates
- Enumerated
- 2021-06-02
- Last updated
- 2021-06-02
- Certified
- 2021-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.