Indy Dental Group North Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009482A Issued in IN

Legal business name

INDY DENTAL GROUP NORTH INC.

Practice address

322 W Main St
Westfield, IN 46074-9384

Phone

(317) 571-1900

Fax

(317) 569-9695

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jack M Miller, DDS

Title

Owner

Phone

(317) 571-1900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1033659487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 W MAIN ST",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749384",
            "telephone_number": "317-571-1900",
            "fax_number": "317-569-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W MAIN ST",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460749384",
            "telephone_number": "317-571-1900",
            "fax_number": "317-569-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY DENTAL GROUP NORTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-571-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009482A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Ann Huntley
• Leah Huston
• Linda Jean Hutchins, RPH
• Indiana Re-Entry Integration
• Indiana Respiratory Services, LLC
• Indy Dental Group Sleep, LLC
• Indy Dental Group Westfield
• Indy Dental Group WF, Inc.
• Indy Eyes, LLC
• Alexandra Jane Ingall, PHARMD

• General Practice Dentistry in Westfield, IN
• Providers in Westfield, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.