Ian Bradley Emerson, DMD
Individual provider Active NPI General Practice Dentistry · Georgetown, IN
NPI 1316507494 · NPPES record last updated Jun 19, 2019
Key facts
- NPI
- 1316507494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12013183A (IN)
- Practice address
- 9215 State Road 64
Georgetown, IN 47122-8833 - Phone
- (812) 951-3776
- NPI assigned
- Jun 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12013183A | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12013183A | IN | Yes |
Addresses
Primary practice location
9215 State Road 64
Georgetown, IN 47122-8833
Mailing address
PO Box 105
Georgetown, IN 47122-0105
Other providers in Georgetown, IN
- Dental Staffing Solutions/Steinwedel LLC
- Meenu Dhiman
- Kerrin Courtney Dunn
- Elm Counseling Associates
- Carrie Emerson
- Richard L Emerson
- Victoria S Evans
- Rachel Michelle Eve
- Floyd Memorial Hospital and Health Services
- Tonja F Foster
All providers in Georgetown, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.