NPIMap

Organization Active NPI

Ez Dental and Dentures

  • General Practice Dentistry
  • Carmel, IN
National Provider Identifier
1003066028
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009121A Issued in IN
Legal business name
EZ DENTAL AND DENTURES
Practice address
14904 Greyhound CT
Carmel, IN 46032-1091
Phone
(317) 566-3300
Fax
(317) 566-3302
NPI assigned
Sep 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tom Dooley
Title
Chief Operating Officer
Phone
(317) 566-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12009121A IN Primary

Addresses

Primary practice location

14904 Greyhound CT
Carmel, IN 46032-1091

Mailing address

14904 Greyhound CT
Carmel, IN 46032-1091
Phone (317) 566-3300

Other identifiers 1

IdentifierTypeStateIssuer
200903800AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1003066028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14904 GREYHOUND CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321091",
            "telephone_number": "317-566-3300",
            "fax_number": "317-566-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14904 GREYHOUND CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321091",
            "telephone_number": "317-566-3300",
            "fax_number": "317-566-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ DENTAL AND DENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "DOOLEY",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "317-566-3300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009121A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200903800A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.