Healthcare Provider Details

I. General information

NPI: 1750113502
Provider Name (Legal Business Name): EMILY HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9380 E 400 S
PIERCETON IN
46562-9287
US

IV. Provider business mailing address

9380 E 400 S
PIERCETON IN
46562-9287
US

V. Phone/Fax

Practice location:
  • Phone: 574-549-0004
  • Fax:
Mailing address:
  • Phone: 574-549-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number12014764A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: