NPIMap

Organization Active NPI

Dental Professionals of Indiana, P.C.

  • General Practice Dentistry
  • Westfield, IN
National Provider Identifier
1487497467
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF INDIANA, P.C.
Doing business as
Grand Maple Dental Care
Practice address
249 W Tournament TRL
Westfield, IN 46074-6223
Phone
(463) 622-2060
Fax
(463) 622-2059
NPI assigned
Jun 17, 2024
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

249 W Tournament TRL
Westfield, IN 46074-6223

Mailing address

249 W Tournament TRL
Westfield, IN 46074-6223
Phone (463) 622-2060

Other names 1

  • Grand Maple Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Indiana PC48 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Indiana PC

Other organizations with this tax ID 47

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

View all 47

Locations

249 W Tournament Trl
Westfield, IN 46074
Phone (463) 622-2060

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1487497467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 W TOURNAMENT TRL",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460746223",
            "telephone_number": "463-622-2060",
            "fax_number": "463-622-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 W TOURNAMENT TRL",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460746223",
            "telephone_number": "463-622-2060",
            "fax_number": "463-622-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF INDIANA, P.C.",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Maple Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.