Edp of Indiana, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EDP OF INDIANA, PC

Practice address

5470 Lafayette Rd
Indianapolis, IN 46254-1620

Phone

(317) 293-4611

NPI assigned

Dec 27, 2017

Organization subpart

No

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

Authorized official

Name

Roseanne Brunenkant

Title

Director of Integration

Phone

(312) 937-3619

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1548776685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W JACKSON BLVD STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043048",
            "telephone_number": "312-937-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 LAFAYETTE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541620",
            "telephone_number": "317-293-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDP OF INDIANA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRUNENKANT",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATION",
        "authorized_official_telephone_number": "312-937-3619"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronnisha N Edmondson
• Edmund L. Rapp, D.D.S., M.S.D., P.C.
• Farris Edmundson
• Ryan Ednalino
• Rodrigo Del Castillo Edo, RPT
• Kelly J. Edsall, NP
• Educational Destinations Inc.
• Mary K Edwards-Brown, M.D.
• Anna M Edwards, MD
• Ashlyn Edwards

• Dental Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.