HealthLinc - South Bend Dental – Federally Qualified Health Center (FQHC), NPI 1679954804

HealthLinc - South Bend Dental is a healthcare provider. based in Valparaiso, Indiana. specializing in Federally Qualified Health Center (FQHC). The NPI Number for HealthLinc - South Bend Dental is 1679954804

Main info

Organization
Name
HealthLinc - South Bend Dental
NPI
1679954804
Phone
(219) 413-5100
Address
2401 VALLEY DR
Authorized Official
MELISSA MITCHELL CEO
Enumeration Date
12 June 2015
Last Update Date
12 January 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness80
Years active:11State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for HealthLinc - South Bend Dental

  • 2401 VALLEY DR

    VALPARAISO, IN 463832520

    Phone: (219) 413-5100

    Fax: (219) 465-9507

    Type: Mailing

  • 1002 S ESTHER ST

    SOUTH BEND, IN 46615

    Phone: (219) 477-6082

    Fax: (219) 465-9502

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-01-31 (863 days ago).

Enrollment records

1

Earliest due date

2024-01-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20150814014686OFederally Qualified Health Center (Fqhc)IN2024-01-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46383)

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Reviews

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Frequently asked questions

Is there an official ID for HealthLinc - South Bend Dental in U.S. healthcare records?
The official identifier for HealthLinc - South Bend Dental is NPI 1679954804.
Is there an active status for HealthLinc - South Bend Dental?
For scheduling context, HealthLinc - South Bend Dental is shown as active in the registry.
What expertise is attributed to HealthLinc - South Bend Dental?
HealthLinc - South Bend Dental's specialty line reads Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is HealthLinc - South Bend Dental located near Valparaiso?
HealthLinc - South Bend Dental currently maps to Valparaiso, Indiana in this extract.
When was this NPI issued?
Enumeration for HealthLinc - South Bend Dental is noted as June 12, 2015 where the registry provides it.

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