NPIMap

Organization Active NPI

Paradise Dental LLC

  • Dental Clinic/Center
  • Indianapolis, IN
National Provider Identifier
1124503966
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PARADISE DENTAL LLC
Practice address
4745 Statesmen Dr Ste E
Indianapolis, IN 46250-5649
Phone
(317) 643-7117
Fax
(317) 643-7112
NPI assigned
Sep 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
Huong T Vu, DDSNPI 1285870394
Title
Owner/Dentist
Phone
(317) 643-7117

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4745 Statesmen Dr Ste E
Indianapolis, IN 46250-5649

Mailing address

4745 Statesmen Dr Ste E
Indianapolis, IN 46250-5649
Phone (317) 643-7117

Other names 1

  • Paradise Dental Other name

National Provider Directory

National Provider Directory

Locations

4745 Statesmen Dr
Ste E
Indianapolis, IN 46250
Phone (317) 643-7117

Practitioners & affiliated clinicians

Practitioners 1

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": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1124503966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 STATESMEN DR STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505649",
            "telephone_number": "317-643-7117",
            "fax_number": "317-643-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 STATESMEN DR STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505649",
            "telephone_number": "317-643-7117",
            "fax_number": "317-643-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "HUONG",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "317-643-7117",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.