Isabel Antoinette Bravo, DDS
Individual provider Active NPI Dentist · Merrillville, IN
NPI 1073357752 · NPPES record last updated Jun 19, 2024
Key facts
- NPI
- 1073357752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12014466A (IN)
- Practice address
- 233 E 84TH Dr Ste 106
Merrillville, IN 46410-6454 - Phone
- (219) 736-2309
- NPI assigned
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014466A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beck Dental Center, P.C. | Current |
Accepting new patients |
Locations
233 E 84th Dr
Ste 106
Merrillville, IN 46410
Phone (219) 736-2309
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12014466A | IN | Yes |
Addresses
Primary practice location
233 E 84TH Dr Ste 106
Merrillville, IN 46410-6454
Mailing address
192 Wexford Rd
Valparaiso, IN 46385-8047
Phone (219) 477-8384
Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.