NPIMap

Organization Active NPI

Fishers Pediatric Dentistry

  • Pediatric Dentistry
  • Fishers, IN
National Provider Identifier
1295815835
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12009305B Issued in IN
Legal business name
FISHERS PEDIATRIC DENTISTRY
Practice address
9124 Technology Dr
Suite 100
Fishers, IN 46038-3064
Phone
(317) 598-9898
Fax
(317) 596-9659
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kerri Rummell
Title
Front Office Coordinator
Phone
(317) 598-9898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 12009305B IN Primary

Addresses

Primary practice location

9124 Technology Dr
Suite 100
Fishers, IN 46038-3064

Mailing address

9124 Technology Dr
Suite 100
Fishers, IN 46038-3064
Phone (317) 598-9898

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295815835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 TECHNOLOGY DR",
            "address_2": "SUITE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383064",
            "telephone_number": "317-598-9898",
            "fax_number": "317-596-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9124 TECHNOLOGY DR",
            "address_2": "SUITE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460383064",
            "telephone_number": "317-598-9898",
            "fax_number": "317-596-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHERS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUMMELL",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "FRONT OFFICE COORDINATOR",
        "authorized_official_telephone_number": "317-598-9898"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12009305B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.