Individual provider Active NPI

Lauren Redditi Hanzlik, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Zionsville, IN
National Provider Identifier
1447679659
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12011390A Issued in IN
Practice address
12036 N Michigan Rd Ste 200
Zionsville, IN 46077-8782
Phone
(317) 733-0926
Fax
(317) 733-0950
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12011390A IN Primary

Addresses

Primary practice location

12036 N Michigan Rd Ste 200
Zionsville, IN 46077-8782

Mailing address

10972 Allisonville Rd Ste 110
Fishers, IN 46038-2639
Phone (317) 913-2363

Other practice location 1

3021 E 98th St Ste 250
Indianapolis, IN 46280-2908
Phone (317) 846-3446

Other identifiers 1

IdentifierTypeStateIssuer
201360900MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011390AINMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: lhanzlik450909@ecommunitydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1447679659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10972 ALLISONVILLE RD STE 110",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382639",
            "telephone_number": "317-913-2363",
            "fax_number": "317-913-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12036 N MICHIGAN RD STE 200",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778782",
            "telephone_number": "317-733-0926",
            "fax_number": "317-733-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3021 E 98th St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462802908",
            "country_code": "US",
            "telephone_number": "317-846-3446",
            "fax_number": "317-574-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANZLIK",
        "first_name": "LAUREN",
        "middle_name": "REDDITI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011390A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201360900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.