Indy Dental Health-Shelbyville

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

INDY DENTAL HEALTH-SHELBYVILLE

Practice address

122 Lee Blvd
Shelbyville, IN 46176-3403

Phone

(317) 398-6399

Fax

(317) 398-6362

NPI assigned

Jun 25, 2021

Organization subpart

No

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

Authorized official

Name

Matthew Fraiz, DMDNPI 1134351091

Title

Dentist-Owner

Phone

(317) 872-3465

Specialties & licenses 1

Addresses

Other names 1

• SHELBYVILLE DENTAL Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Fraiz, D.M.D.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1134351091
  NPD (past) Authorized official
• Mallory Lynn Michalke-Griffith, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1740578491
  NPD (past)

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1184294837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 N MERIDIAN ST STE 225",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601837",
            "telephone_number": "317-872-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LEE BLVD",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461763403",
            "telephone_number": "317-398-6399",
            "fax_number": "317-398-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY DENTAL HEALTH-SHELBYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "FRAIZ",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST-OWNER",
        "authorized_official_telephone_number": "317-872-3465",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHELBYVILLE DENTAL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shea Robert Idlewine, FNP-C
• Indiana Heart Physicians, Inc
• Indiana Orthopaedic Center
• Indiana Orthopaedic Center
• Indianapolis Vamc
• Infinity Home Care LLC
• Infinity Home Care Plus Inc
• Infinity Home Health Care
• Infinity Home Health Inc
• Infusion Center of Indiana LLC

• Dental Clinic/Center in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.