NPIMap

Organization Active NPI

Indy Dental Group 93Rd, Inc.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1366531196
Registry record updated Jan 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009479 Issued in IN
Legal business name
INDY DENTAL GROUP 93RD, INC.
Practice address
9310 N Meridian St Ste 200
Indianapolis, IN 46260-1806
Phone
(317) 846-6125
Fax
(317) 846-6282
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2014

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

Authorized official

Name
Dr. Elizabeth B Lewis, DDS
Title
Owner
Phone
(317) 571-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12009479 IN Primary

Addresses

Primary practice location

9310 N Meridian St Ste 200
Indianapolis, IN 46260-1806

Mailing address

9310 N Meridian St Ste 200
Indianapolis, IN 46260-1806
Phone (317) 846-6125

Other names 1

  • INDY DENTAL GROUP, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

9310 N Meridian St
Ste 200
Indianapolis, IN 46260
Phone (317) 846-6125

Practitioners & affiliated clinicians

Practitioners 8

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388534400000",
    "number": "1366531196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 N MERIDIAN ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601806",
            "telephone_number": "317-846-6125",
            "fax_number": "317-846-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 N MERIDIAN ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601806",
            "telephone_number": "317-846-6125",
            "fax_number": "317-846-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY DENTAL GROUP 93RD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-01-01",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-571-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDY DENTAL GROUP, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 1, 2014; 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.