Organization Active NPI

Kids ENT of Indiana LLC

  • Pediatric Otolaryngology Physician
  • Indianapolis, IN
National Provider Identifier
1376044784
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
Legal business name
KIDS ENT OF INDIANA LLC
Practice address
8240 Naab Rd Ste 150
Indianapolis, IN 46260-1974
Phone
(317) 903-4675
Fax
(317) 614-7154
NPI assigned
Feb 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Dr. Dean Trigg, MDNPI 1427015833
Title
President
Phone
(773) 386-7035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YP0228X Primary

Addresses

Primary practice location

8240 Naab Rd Ste 150
Indianapolis, IN 46260-1974

Mailing address

10111 Ditch Rd
Carmel, IN 46032-8897

Other identifiers 1

IdentifierTypeStateIssuer
200859540MedicaidIN

National Provider Directory

National Provider Directory

Locations

8240 Naab Rd
Ste 150
Indianapolis, IN 46260
Phone (317) 903-4675

Practitioners & affiliated clinicians

Practitioners 1

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": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1376044784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 DITCH RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 NAAB RD STE 150",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601974",
            "telephone_number": "317-903-4675",
            "fax_number": "317-614-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS ENT OF INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "TRIGG",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-386-7035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200859540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 10, 2022; 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.