Organization Active NPI

Newberry Dental

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1194235291
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012423A Issued in IN
Legal business name
NEWBERRY DENTAL
Practice address
135 N Shortridge Rd Ste A1
Indianapolis, IN 46219-8905
Phone
(317) 203-3424
NPI assigned
Oct 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Authorized official

Name
Dr. Emily Jane Horcha, DMD
Title
Owner
Phone
(317) 203-3424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12012423A IN Primary

Addresses

Primary practice location

135 N Shortridge Rd Ste A1
Indianapolis, IN 46219-8905

Mailing address

135 N Shortridge Rd Ste A1
Indianapolis, IN 46219-8905
Phone (317) 203-3424

Other identifiers 1

IdentifierTypeStateIssuer
201328700MedicaidIN

National Provider Directory

National Provider Directory

Locations

135 N Shortridge Rd
Ste A1
Indianapolis, IN 46219
Phone (317) 203-3424

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1194235291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N SHORTRIDGE RD STE A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462198905",
            "telephone_number": "317-203-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N SHORTRIDGE RD STE A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462198905",
            "telephone_number": "317-203-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "HORCHA",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-203-3424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012423A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201328700",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 3, 2017; 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.