Laura L Durell, DDS
Individual provider Active NPI Dentist · Plainfield, IN
NPI 1104047059 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104047059
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12009347 (IN)
- Practice address
- 1301 Agan Dr
Plainfield, IN 46168-7715 - Phone
- (317) 839-6106
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241211002437 | IN | Practitioner - Dentist | 0042746224 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009347 | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aria Dental Care PC | Dentist | Current |
Accepting new patients |
| Durell & Durell DDS PC | Dentist | Past | Accepting new patients |
Locations
200 Byrd Way
Ste 205
Greenwood, IN 46143
8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12009347 | IN | Yes |
Addresses
Primary practice location
1301 Agan Dr
Plainfield, IN 46168-7715
Mailing address
PO Box 236
Plainfield, IN 46168-0236
Phone (317) 839-6106
Other providers in Plainfield, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.