NPIMap

Organization Active NPI

Louly Dentistry, Inc

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1003104043
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LOULY DENTISTRY, INC
Practice address
11530 E Washington Street
Indianapolis, IN 46229-2828
Phone
(317) 869-0000
Fax
(317) 869-0233
NPI assigned
Jul 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Dr. Ammar C. Louly, DDSNPI 1699808899
Title
President
Phone
(317) 869-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X 12009247A IN
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

11530 E Washington Street
Indianapolis, IN 46229-2828

Mailing address

11530 E Washington Street
Indianapolis, IN 46229-2828
Phone (317) 869-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110713000443 IN Part B Supplier - Clinic/Group Practice 4082882360 Receives reassigned benefits from 1 practitioner
Practice locations: Indianapolis, IN
O20110829000211 IN DME Supplier - Oral Surgery - Dentist 4082882360 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

9602 E Washington St
Ste A
Indianapolis, IN 46229
Phone (317) 869-0000

Practitioners & affiliated clinicians

Practitioners 1

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": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1003104043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 E WASHINGTON STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292828",
            "telephone_number": "317-869-0000",
            "fax_number": "317-869-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 E WASHINGTON STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292828",
            "telephone_number": "317-869-0000",
            "fax_number": "317-869-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOULY DENTISTRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "LOULY",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-869-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "IN",
            "license": "12009247A",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.