NPIMap

Organization Active NPI

Indianapolis Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Indianapolis, IN
National Provider Identifier
1205224433
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12010493A Issued in IN
Legal business name
INDIANAPOLIS PEDIATRIC DENTISTRY LLC
Practice address
8433 Harcourt Rd
Suite 307
Indianapolis, IN 46260-2190
Phone
(317) 872-7272
NPI assigned
Dec 22, 2014
Last updated
Dec 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Dr. Erin Fuson Phillips, DDSNPI 1558337311
Title
Member
Phone
(317) 872-7272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 12010493A IN Primary

Addresses

Primary practice location

8433 Harcourt Rd
Suite 307
Indianapolis, IN 46260-2190

Mailing address

8433 Harcourt Rd
Suite 307
Indianapolis, IN 46260-2190
Phone (317) 872-7272

National Provider Directory

National Provider Directory

Locations

8433 Harcourt Rd
Ste 307
Indianapolis, IN 46260
Phone (317) 872-7272

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1205224433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD",
            "address_2": "SUITE 307",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602190",
            "telephone_number": "317-872-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8433 HARCOURT RD",
            "address_2": "SUITE 307",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602190",
            "telephone_number": "317-872-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "FUSON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-872-7272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12010493A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 22, 2014; 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.