Washington Street Dentistry Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WASHINGTON STREET DENTISTRY INC.

Doing business as

Washington Street Dentistry

Practice address

10935 E Washington St
Suite a
Indianapolis, IN 46229-3181

Phone

(317) 890-4435

Fax

(317) 890-4460

NPI assigned

Sep 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Matthew E Church, D.M.D.NPI 1033127063

Title

Owner/Dentist

Phone

(317) 336-6723

Specialties & licenses 1

Addresses

Other names 1

• Washington Street Dentistry Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

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

• Matthew E Church, D.D.S.

  • Dentist
  • Indianapolis, IN
  • NPI 1033127063
  Medicare reassignment NPD Authorized official
• Daniel Bearss Roberts, M.D.

  • Surgery Physician
  • Indianapolis, IN
  • NPI 1861832131
  NPD (past)

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1225286099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10935 E WASHINGTON ST",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462293181",
            "telephone_number": "317-890-4435",
            "fax_number": "317-890-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10935 E WASHINGTON ST",
            "address_2": "SUITE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462293181",
            "telephone_number": "317-890-4435",
            "fax_number": "317-890-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON STREET DENTISTRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "317-336-6723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Street Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Jean Washam, MA, LMHCA
• Jesseca Wardwell Washburn, NP
• Kathleen Elizabeth Washburn
• Monica Lee Washburn, NP
• Washington Eye Center, P.C.
• Washington Township Fire Department
• Washington Transportation Services LLC (Washington Transportation Services)
• Onita Washington-Lackey
• Alana Washington, PHARMD
• Antwone Lamonte Washington

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.