Active NPI
Lauren Redditi Hanzlik, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Zionsville, IN
National Provider Identifier
1447679659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 12011390A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201360900 | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12011390A | IN | MD | Oral and Maxillofacial Surgery (Dentist) |
Interoperability endpoints
- 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.