86TH Street Complete Dental LLC
Organization Active NPI Dental Clinic/Center · Indianapolis, IN
NPI 1194247940 · NPPES record last updated Feb 26, 2024
Key facts
- NPI
- 1194247940
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- 86TH STREET COMPLETE DENTAL LLC
- Practice address
- 3810 W 86TH St
Indianapolis, IN 46268 - Phone
- (317) 707-6453
- NPI assigned
- Jul 13, 2017
- Organization subpart
- No
Authorized official
- Name
- Mona P Singh
- Title
- Owner
- Phone
- (317) 748-4603
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
3810 W 86TH St
Indianapolis, IN 46268
Mailing address
3810 W 86TH St
Indianapolis, IN 46268-1905
Phone (317) 707-6453
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300015766 | Medicaid | IN |
Other names
- 86TH STREET Complete Dental
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2024. 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.