Organization Active NPI

MFDC of Indiana, Inc

Doing business as Georgetown Dental Center

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1538970934
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MFDC OF INDIANA, INC
Doing business as
Georgetown Dental Center
Practice address
5525 Georgetown Rd Ste B
Indianapolis, IN 46254-3717
Phone
(502) 254-8500
NPI assigned
Jan 15, 2025
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Jennifer Pardue
Title
Director of Revenue Cycle
Phone
(502) 548-2402

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary
Pediatric Dentistry 1223P0221X

Addresses

Primary practice location

5525 Georgetown Rd Ste B
Indianapolis, IN 46254-3717

Mailing address

PO Box 437169
Louisville, KY 40253-7169
Phone (502) 254-8500

Other names 1

  • Georgetown Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MFDC of Indiana Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1538970934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169",
            "telephone_number": "502-254-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 GEORGETOWN RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462543717",
            "telephone_number": "502-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MFDC OF INDIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "PARDUE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "502-548-2402"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgetown Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 10, 2025; 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.