Northside Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12010349A Issued in IN

Legal business name

NORTHSIDE DENTAL LLC

Practice address

15026 Greyhound CT
Carmel, IN 46032-1015

Phone

(317) 842-8453

NPI assigned

Jul 3, 2018

Organization subpart

No

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

Authorized official

Name

Ashley Thurman

Title

Office Manager

Phone

(317) 842-8453

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530576000000",
    "number": "1558857540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15026 GREYHOUND CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15026 GREYHOUND CT",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321015",
            "telephone_number": "317-842-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A",
        "authorized_official_last_name": "THURMAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-842-8453"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IN",
            "license": "12010349A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300002251",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Jane Norris, MD
• Philip Corey Norswether
• North GYN PC
• North Meridian Street Surgicenter Associates, LLC
• Jennifer Northcutt
• Northside ENT, Inc
• Northside Foot Clinic, Inc.
• Northside Hearing Care
• Northside Psychotherapeutics
• Leah Notar Donato, DPT

• Dental Clinic/Center in Carmel, IN
• Providers in Carmel, 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 Jul 3, 2018; 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.