Incredible Changes Dentistry, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009491A Issued in IN

Legal business name

INCREDIBLE CHANGES DENTISTRY, P.C.

Practice address

4758 S Scatterfield Rd
Anderson, IN 46013-2908

Phone

(765) 642-9500

NPI assigned

Oct 30, 2007

Last updated

Oct 30, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven Salkeld I

Title

Owner

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1578742292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 SANDERS CREEK PKWY",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130571307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4758 S SCATTERFIELD RD",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460132908",
            "telephone_number": "765-642-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCREDIBLE CHANGES DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "SALKELD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009491A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Anderson, IN
• Providers in Anderson, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.