Margot L. Van Dis, D.D.S.

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

12009292 Issued in IN

Practice address

1121 W Michigan St
Indianapolis, IN 46202-5211

Phone

(317) 274-5580

Fax

(317) 278-3018

NPI assigned

Mar 14, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396878799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 WOOD STREAM DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462549619",
            "telephone_number": "317-274-5580",
            "fax_number": "317-278-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-5580",
            "fax_number": "317-278-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DIS",
        "first_name": "MARGOT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "IN",
            "license": "12009292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ryan Vallely, LAT, ATC
• Shailaja Valluri, MD
• Valor Healthcare Solutions LLC
• Nakul Valsangkar, MD
• Ashley Lynn Van Buskirk, PT, DPT
• Claire O Van Koevering
• Amanda Van Milligan, LMHC
• Bruce W Van Natta, MD
• Madison Elaina Van Ooyen, PT
• Brenda Van Schaick-Bianchi

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.