NPIMap

Organization Active NPI

Manoj K Bahl, DDS, PC

Doing business as Excel Dental Studio

  • General Practice Dentistry
  • Merrillville, IN
National Provider Identifier
1295118172
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011727A Issued in IN
Legal business name
MANOJ K BAHL, DDS, PC
Doing business as
Excel Dental Studio
Practice address
40 W 73Rd Ave
Merrillville, IN 46410-3979
Phone
(219) 769-3305
Fax
(219) 769-4674
NPI assigned
Jul 9, 2015
Last updated
Sep 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Dr. Manoj K Bahl, DDS, PCNPI 1578683892
Title
Owner/Dentist
Phone
(219) 769-3305

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
General Practice Dentistry 1223G0001X 12011727A IN Primary

Addresses

Primary practice location

40 W 73Rd Ave
Merrillville, IN 46410-3979

Mailing address

40 W 73Rd Ave
Merrillville, IN 46410-3979
Phone (219) 769-3305

Other identifiers 1

IdentifierTypeStateIssuer
201300110AMedicaidIN

Other names 1

  • Excel Dental Studio Doing business as

National Provider Directory

National Provider Directory

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": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1295118172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W 73RD AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103979",
            "telephone_number": "219-769-3305",
            "fax_number": "219-769-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W 73RD AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103979",
            "telephone_number": "219-769-3305",
            "fax_number": "219-769-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOJ K BAHL, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "BAHL",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "219-769-3305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011727A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201300110A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.