NPIMap

Organization Active NPI

Madison Ave Dental LLC

  • Dentist
  • Greenwood, IN
National Provider Identifier
1063993582
Registry record updated Dec 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011832A Issued in IN
Legal business name
MADISON AVE DENTAL LLC
Practice address
701 N Madison Ave
Greenwood, IN 46142-4126
Phone
(317) 881-4305
NPI assigned
Aug 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2020

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

Authorized official

Name
Dr. Kurush Savabi, DDSNPI 1235493487
Title
Owner
Phone
(317) 417-7486

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12011832A IN Primary

Addresses

Primary practice location

701 N Madison Ave
Greenwood, IN 46142-4126

Mailing address

701 N Madison Ave
Greenwood, IN 46142-4126
Phone (317) 881-4305

National Provider Directory

National Provider Directory

Locations

701 N Madison Ave
Greenwood, IN 46142
Phone (317) 881-4305

Practitioners & affiliated clinicians

Practitioners 3

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": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607212800000",
    "number": "1063993582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461424126",
            "telephone_number": "317-881-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461424126",
            "telephone_number": "317-881-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2020-12-06",
        "certification_date": "2020-12-06",
        "status": "A",
        "authorized_official_last_name": "SAVABI",
        "authorized_official_first_name": "KURUSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-417-7486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011832A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

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