Premier Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12012422A Issued in IN

Legal business name

PREMIER ORTHODONTICS LLC

Practice address

8860 Zionsville Rd Ste B
Indianapolis, IN 46268-1043

Phone

(317) 998-7645

NPI assigned

Jun 9, 2017

Organization subpart

No

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

Authorized official

Name

Syrah Imtiaz Quraishi, DDS, MS

Title

Owner

Phone

(317) 998-7645

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063941391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8860 ZIONSVILLE RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681043",
            "telephone_number": "317-998-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8860 ZIONSVILLE RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681043",
            "telephone_number": "317-998-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "QURAISHI",
        "authorized_official_first_name": "SYRAH",
        "authorized_official_middle_name": "IMTIAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-998-7645",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12012422A",
            "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 Jul 21, 2022; 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.