Fountain Square Westend Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FOUNTAIN SQUARE WESTEND DENTAL LLC

Practice address

1535 Prospect St
Indianapolis, IN 46203-2053

Phone

(734) 369-7375

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Pooja Mandalia, DDSNPI 1922395474

Title

Owner

Phone

(734) 369-7371

Specialties & licenses 1

Addresses

Other names 1

• Westend Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pooja Naginroy Mandalia, DDS

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1922395474
  NPD Authorized official
• Deept Rana, D.D.S

  • Dentist
  • Indianapolis, IN
  • NPI 1831486380

  General Practice

  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1639680838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 WINDBOROUGH",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 PROSPECT ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462032053",
            "telephone_number": "734-369-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN SQUARE WESTEND DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "MANDALIA",
        "authorized_official_first_name": "POOJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-369-7371",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westend Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Michael Foulk, MD
• Fountain of Care Inc.
• Fountain of Love Care LLC
• Fountain Square Counseling LLC
• Fountain Square Eye Care
• James Alan Fountain, MD
• Four Seasons Home Care LLC
• Four Seasons Home Health Care LLC
• Four Seasons Transportation Service LLC
• Kimberly Foust

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, 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 16, 2017; 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.