NPIMap

Organization Active NPI

My Indy Dental Center LLC

  • Dental Clinic/Center
  • Indianapolis, IN
National Provider Identifier
1265101315
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MY INDY DENTAL CENTER LLC
Practice address
3804 N Delaware St
Indianapolis, IN 46205-2648
Phone
(317) 925-4202
NPI assigned
Sep 11, 2021
Last updated
Sep 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Authorized official

Name
Dr. Brent J Barta, DDSNPI 1821194093
Title
Member
Phone
(317) 247-9512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3804 N Delaware St
Indianapolis, IN 46205-2648

Mailing address

6443 W 10TH St Ste 204
Indianapolis, IN 46214-6502
Phone (317) 247-9512

National Provider Directory

National Provider Directory

Locations

3804 N Delaware St
Indianapolis, IN 46205
Phone (317) 483-0730

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": "1631318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1265101315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6443 W 10TH ST STE 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462146502",
            "telephone_number": "317-247-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 N DELAWARE ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052648",
            "telephone_number": "317-925-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY INDY DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-11",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A",
        "authorized_official_last_name": "BARTA",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-247-9512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "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 Sep 11, 2021; 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.