NPIMap

Organization Active NPI

MFDC of Indiana, Inc

Doing business as Gentle Dentist - Edgewood

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1306331905
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MFDC OF INDIANA, INC
Doing business as
Gentle Dentist - Edgewood
Practice address
5935 S Emerson Ave Ste 200
Indianapolis, IN 46237-1975
Phone
(317) 784-9400
Fax
(317) 781-1823
NPI assigned
Jun 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Jeff Reibel
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5935 S Emerson Ave Ste 200
Indianapolis, IN 46237-1975

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Other names 1

  • Gentle Dentist - Edgewood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MFDC of Indiana Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

5935 S Emerson Ave
Ste 200
Indianapolis, IN 46237
Phone (317) 359-3888

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1306331905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5935 S EMERSON AVE STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462371975",
            "telephone_number": "317-784-9400",
            "fax_number": "317-781-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MFDC OF INDIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "REIBEL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dentist - Edgewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 6, 2023; 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.