Fishers Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FISHERS FAMILY DENTAL, LLC

Practice address

9865 E 116TH St Ste 100
Fishers, IN 46037-9237

Phone

(317) 570-5480

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Ashley Coad

Title

Credentialing Specialist

Phone

(317) 570-5480

Specialties & licenses 1

Addresses

Practitioners 1

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

• Samuel Bacon, D.D.S.

  • Dentist
  • Fishers, IN
  • NPI 1811070857
  NPD (past)

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1366088056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9865 E 116TH ST STE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379237",
            "telephone_number": "317-570-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9865 E 116TH ST STE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379237",
            "telephone_number": "317-570-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHERS FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "COAD",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "317-570-5480"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fishers Clinic and Med Spa LLC
• Fishers Dental Care, P.C.
• Fishers Digestive Care
• Fishers Eye Care Optometry LLC
• Fishers Eye Care, LLC
• Fishers Family Dentistry, PC
• Fishers Family Physicians
• Fishers Family Vision Center Inc
• Fishers Operator, LLC
• Fishers Oral & Maxillofacial Surgery

• General Practice Dentistry in Fishers, IN
• Providers in Fishers, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.