NPIMap

Organization Active NPI

Immediadent of Indiana, P.C.

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1427583103
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IMMEDIADENT OF INDIANA, P.C.
Practice address
6150 E 82ND St # 100
Indianapolis, IN 46250-1500
Phone
(913) 428-1684
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Authorized official

Name
Jacquelynn R Adkins
Title
Sr. Accounting Manager
Phone
(913) 428-1684

Specialties & licenses 1

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

Addresses

Primary practice location

6150 E 82ND St # 100
Indianapolis, IN 46250-1500

Mailing address

PO Box 11568
Overland Park, KS 66207-4268
Phone (913) 428-1686

Other names 1

  • ImmediaDent Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Immediadent of Indiana PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

Subparts reporting this organization as parent 9

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564358400000",
    "number": "1427583103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11568",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074268",
            "telephone_number": "913-428-1686",
            "fax_number": "866-591-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 E 82ND ST # 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501500",
            "telephone_number": "913-428-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIADENT OF INDIANA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2019-07-29",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "JACQUELYNN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SR. ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "913-428-1684"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 29, 2019; 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.