Indiana Oral & Maxillofacial Surgery Associates PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC

Practice address

10972 Allisonville Rd
Suite 110
Fishers, IN 46038-2637

Phone

(317) 913-2363

Fax

(317) 913-2370

NPI assigned

May 18, 2006

Last updated

Mar 13, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keith Miller

Title

Administrator

Phone

(317) 913-2363

Specialties & licenses 1

Addresses

Other names 1

• Indiana Oral and Maxillofacial Surgery Associates Other name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathan Beker, DMD MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fishers, IN
  • NPI 1407389802
  Medicare reassignment Care Compare group NPD
• Matthew D Bojrab, D.D.S., M.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishers, IN
  • NPI 1043308968
  Medicare reassignment Care Compare group NPD
• Matthew Miller Davis, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1740417898
  Medicare reassignment Care Compare group NPD
• Natalie Anne Muir Eden, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishers, IN
  • NPI 1316179658
  Medicare reassignment Care Compare group NPD
• Christopher T. Kirkup, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Zionsville, IN
  • NPI 1497787220
  Medicare reassignment Care Compare group NPD
• Philip M Montefalco, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1437103017
  Medicare reassignment Care Compare group NPD
• David M Montes, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1407952609
  Medicare reassignment Care Compare group NPD
• Tyler J Potter, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenwood, IN
  • NPI 1992749402
  Medicare reassignment Care Compare group NPD
• John W Pruitt, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenwood, IN
  • NPI 1821045147
  Medicare reassignment Care Compare group NPD
• John Joseph Schier Jr., DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1932440054
  Medicare reassignment Care Compare group NPD
• Samuel Albert Tancredi, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1073783478
  Medicare reassignment Care Compare group NPD
• Brent Thomas Garrison, D.D.S, M.S.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
  • NPI 1134126485
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1407809585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10972 ALLISONVILLE RD",
            "address_2": "SUITE 110",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382637",
            "telephone_number": "317-913-2363",
            "fax_number": "317-913-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10972 ALLISONVILLE RD",
            "address_2": "SUITE 110",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382637",
            "telephone_number": "317-913-2363",
            "fax_number": "317-913-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-913-2363"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Oral and Maxillofacial Surgery Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Fishers, IN
• Providers in Fishers, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.