Active NPI
Elena Olegovna Bya, D.D.S.
- Dentist
- Indianapolis, IN
National Provider Identifier
1457036261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014068A
- Practice address
- 6202 Evanston Ave
Indianapolis, IN 46220-2100 - Phone
- (317) 251-0085
- NPI assigned
- Jun 19, 2023
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12014068A | IN | Primary |
Addresses
Primary practice location
6202 Evanston Ave
Indianapolis, IN 46220-2100
Mailing address
2034 Bellefontaine St
Indianapolis, IN 46202-1856
Phone (812) 325-7761
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014068A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glendale Dental Associates II, P.C. | Current | Accepting new patients |
Locations
6202 Evanston Ave
Indianapolis, IN 46220
Phone (317) 251-0085
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Indianapolis, IN
- NPI 1528246618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1457036261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2034 BELLEFONTAINE ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021856",
"telephone_number": "812-325-7761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6202 EVANSTON AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202100",
"telephone_number": "317-251-0085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYA",
"first_name": "ELENA",
"middle_name": "OLEGOVNA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2023-07-06",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014068A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.