Indigo Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

INDIGO PEDIATRIC DENTISTRY

Practice address

1026 Powdersville Rd Ste a
Easley, SC 29642-2417

Phone

(864) 442-6770

Fax

(864) 442-6830

NPI assigned

Mar 13, 2019

Last updated

Nov 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rula Mahmoud Shalabi, DMDNPI 1609282425

Title

Owner, Pediatric Dentist

Phone

(864) 442-6770

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Rula M Shalabi, DMD PA Former legal business name
• Holly Tree Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rula Mahmoud Shalabi, D.M.D.

  • Pediatric Dentistry
  • Easley, SC
  • NPI 1609282425
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1174082713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 POWDERSVILLE RD STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422417",
            "telephone_number": "864-442-6770",
            "fax_number": "864-442-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 POWDERSVILLE RD STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422417",
            "telephone_number": "864-442-6770",
            "fax_number": "864-442-6830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "SHALABI",
        "authorized_official_first_name": "RULA",
        "authorized_official_middle_name": "MAHMOUD",
        "authorized_official_title_or_position": "OWNER, PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "864-442-6770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA8955",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609282425",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX8355",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rula M Shalabi, DMD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Holly Tree",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatric Dentistry in Easley, SC
• Providers in Easley, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.