W Michael Princell DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

12009143 Issued in IN

Legal business name

W MICHAEL PRINCELL DDS PC

Practice address

7207 N Shadeland Ave
Suite a
Indpls, IN 46250

Phone

(317) 577-2478

Fax

(317) 578-8773

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Martina G Princell, RN

Title

Office Admin

Phone

(317) 577-2478

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053459545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7207 N SHADELAND AVE",
            "address_2": "SUITE A",
            "city": "INDPLS",
            "state": "IN",
            "postal_code": "46250",
            "telephone_number": "317-577-2478",
            "fax_number": "317-578-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7207 N SHADELAND AVE",
            "address_2": "SUITE A",
            "city": "INDPLS",
            "state": "IN",
            "postal_code": "46250",
            "telephone_number": "317-577-2478",
            "fax_number": "317-578-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W MICHAEL PRINCELL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRINCELL",
        "authorized_official_first_name": "MARTINA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "317-577-2478",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.