Scott W Powers, DDS
Individual provider Active NPI General Practice Dentistry · Lyons, IN
NPI 1154367449 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154367449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12010062 (IN)
- Practice address
- 195 E Broad St
Lyons, IN 47443-0236 - Phone
- (812) 659-3901
- Fax
- (812) 659-3903
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 12010062 | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12010062 | IN | Yes |
Addresses
Primary practice location
195 E Broad St
Lyons, IN 47443-0236
Mailing address
PO Box 236
Lyons, IN 47443-0236
Phone (812) 659-3901
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 352116058001 | Other | IN | ANTHEM FEDERAL EMPLOYEE |
Other providers in Lyons, IN
- Brooks Andrew Green
- Gordon Keith Green
- Stephanie Heinrich
- Laura Jones
- Linda C Powers
- William Ray Powers
- Riverview Hospital
- Lau Tran
- Maria Michelle Walker
- William R Powers M.D. Inc.
All providers in Lyons, IN · General Practice Dentistry in Indiana
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.