NPIMap

Organization Active NPI

Dental Professionals of Indiana, PC

  • Dentist
  • Noblesville, IN
National Provider Identifier
1376415273
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL PROFESSIONALS OF INDIANA, PC
Doing business as
Promenade Dental Care
Practice address
5957 Promenade Shops Blvd Ste 105
Noblesville, IN 46062-5620
Phone
(317) 900-4940
NPI assigned
Sep 19, 2025
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5957 Promenade Shops Blvd Ste 105
Noblesville, IN 46062-5620

Mailing address

5957 Promenade Shops Blvd Ste 105
Noblesville, IN 46062-5620

Other names 1

  • Promenade Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Indiana PC48 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Indiana PC

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

5957 Promenade Shops Blvd
Ste 105
Noblesville, IN 46062
Phone (317) 900-4940

NPI Registry JSON

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

{
    "created_epoch": "1758240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1376415273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 PROMENADE SHOPS BLVD STE 105",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460625620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5957 PROMENADE SHOPS BLVD STE 105",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460625620",
            "telephone_number": "317-900-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF INDIANA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promenade Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.