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General NPI Number Information
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NPI Number | 1720639842
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Entity Type | Individual
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Provider Name | NOMIN GROVES DDS
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Gender | Female
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 225 N NOTRE DAME AVE STE 2
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City | SOUTH BEND
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State | IN
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Zip | 46617-2836
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Country | US
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Telephone | 574-233-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 225 N NOTRE DAME AVE STE 2
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City | SOUTH BEND
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State | IN
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Zip | 46617-2836
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Country | US
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Telephone | 574-232-5866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 12013289A
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License Number State | IN
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