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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
300015766MedicaidIN

Other names

  • 86TH STREET Complete Dental Doing business as

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Dental Clinic/Center in Indiana

Sources for this page

Verify at the official NPI Registry.