NPIMap

Organization Active NPI

Fall Creek Dentistry, PC

  • General Practice Dentistry
  • Fishers, IN
National Provider Identifier
1356361679
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010202 Issued in IN
Legal business name
FALL CREEK DENTISTRY, PC
Practice address
10106 Brooks School Rd
Suite 500
Fishers, IN 46037-9804
Phone
(317) 596-8000
Fax
(317) 596-0671
NPI assigned
Jul 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Valerie Edley
Title
Office Manager
Phone
(317) 596-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12010202 IN Primary

Addresses

Primary practice location

10106 Brooks School Rd
Suite 500
Fishers, IN 46037-9804

Mailing address

10106 Brooks School Rd
Suite 500
Fishers, IN 46037-9804
Phone (317) 596-8000

Other identifiers 1

IdentifierTypeStateIssuer
00720339OtherINUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

10106 Brooks School Rd
Ste 500
Fishers, IN 46037
Phone (317) 596-8000

Practitioners & affiliated clinicians

Practitioners 3

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356361679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10106 BROOKS SCHOOL RD",
            "address_2": "SUITE 500",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379804",
            "telephone_number": "317-596-8000",
            "fax_number": "317-596-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10106 BROOKS SCHOOL RD",
            "address_2": "SUITE 500",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379804",
            "telephone_number": "317-596-8000",
            "fax_number": "317-596-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDLEY",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-596-8000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "00720339",
            "state": "IN"
        }
    ],
    "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.