Provider Demographics
NPI:1902111701
Name:KILGORE, CARA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:ANN
Last Name:KILGORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CARA
Other - Middle Name:ANN
Other - Last Name:PIPPENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3434 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1776
Mailing Address - Country:US
Mailing Address - Phone:574-273-8393
Mailing Address - Fax:574-273-8818
Practice Address - Street 1:3434 DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1776
Practice Address - Country:US
Practice Address - Phone:574-273-8393
Practice Address - Fax:874-273-8818
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011471A1223P0221X, 122300000X
PADS0403091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist