Organization Active NPI

Check Ups Dental Center

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1558555607
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010607A Issued in IN
Legal business name
CHECK UPS DENTAL CENTER
Practice address
4456 N Keystone Ave
Indianapolis, IN 46205-2251
Phone
(317) 545-5771
Fax
(317) 545-1678
NPI assigned
Aug 31, 2007
Last updated
Nov 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Dr. Andrey Horton, DDS
Title
Owner/Dentist
Phone
(317) 545-5771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12010607A IN Primary

Addresses

Primary practice location

4456 N Keystone Ave
Indianapolis, IN 46205-2251

Mailing address

4456 N Keystone Ave
Indianapolis, IN 46205-2251
Phone (317) 545-5771

Other identifiers 2

IdentifierTypeStateIssuer
200304660MedicaidIN
200499250MedicaidIN

National Provider Directory

National Provider Directory

Locations

4456 N Keystone Ave
Indianapolis, IN 46205
Phone (317) 545-5771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1558555607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4456 N KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052251",
            "telephone_number": "317-545-5771",
            "fax_number": "317-545-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4456 N KEYSTONE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052251",
            "telephone_number": "317-545-5771",
            "fax_number": "317-545-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHECK UPS DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "ANDREY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "317-545-5771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010607A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200304660",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200499250",
            "state": "IN"
        }
    ],
    "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 Nov 19, 2012; 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.