NPIMap

Organization Active NPI

Keystone Endodontics

  • Endodontics
  • Indianapolis, IN
National Provider Identifier
1033309471
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12009805 Issued in IN
Legal business name
KEYSTONE ENDODONTICS
Practice address
3105 E 98TH St
Suite 130
Indianapolis, IN 46280-2005
Phone
(317) 569-9977
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Authorized official

Name
Dr. Donald G. Anderson I, D.D.S.,M.S.NPI 1649372798
Title
Owner
Phone
(317) 569-9977

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 12009805 IN Primary

Addresses

Primary practice location

3105 E 98TH St
Suite 130
Indianapolis, IN 46280-2005

Mailing address

3105 E 98TH St
Indianapolis, IN 46280-2005
Phone (317) 569-9977

Other identifiers 2

IdentifierTypeStateIssuer
1649372798OtherNPI TYPE I
12009805OtherININDIANA DENTAL LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1033309471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 E 98TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802005",
            "telephone_number": "317-569-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 E 98TH ST",
            "address_2": "SUITE 130",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462802005",
            "telephone_number": "317-569-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-569-9977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "D.D.S.,M.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12009805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1649372798",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA DENTAL LICENSE",
            "identifier": "12009805",
            "state": "IN"
        }
    ],
    "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 Aug 1, 2007; 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.