Indy Dental Group West 86TH, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009479A Issued in IN

Legal business name

INDY DENTAL GROUP WEST 86TH, INC.

Practice address

3711 W 86TH St
Indianapolis, IN 46268-1904

Phone

(317) 571-1900

Fax

(317) 569-9695

NPI assigned

Mar 3, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth B Lewis, DDS

Title

Owner

Phone

(317) 571-1900

Specialties & licenses 1

Addresses

Locations

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chelsea McKnight, DDS

  • Dentist
  • Carmel, IN
  • NPI 1578240842
  NPD (past)

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1477913499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681904",
            "telephone_number": "317-571-1900",
            "fax_number": "317-569-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681904",
            "telephone_number": "317-571-1900",
            "fax_number": "317-569-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDY DENTAL GROUP WEST 86TH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-571-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009479A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indy Counseling and Wellness Group LLC
• Indy Counseling Professionals LLC
• Indy Counseling Solutions, LLC
• Indy Dental and Oral Surgery LLC
• Indy Dental Group 93Rd, Inc.
• Indy Dental Health, LLC
• Indy Dental Implants LLC
• Indy Developmental Residential Service LLC
• Indy East Dental LLC
• Indy East Periodontics PC

• All providers in Indianapolis, IN
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.