Branko Alavanja, D.D.S.
Individual provider Active NPI Dentist · Indianapolis, IN
NPI 1649568437 · NPPES record last updated Jul 14, 2011
Key facts
- NPI
- 1649568437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12011615A (IN)
- Practice address
- 1481 W 10TH St
Dental Service 160
Indianapolis, IN 46202-2803 - Phone
- (317) 310-4294
- NPI assigned
- Jul 14, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011615A | IN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12011615A | IN | Yes |
Addresses
Primary practice location
1481 W 10TH St
Dental Service 160
Indianapolis, IN 46202-2803
Mailing address
1481 W 10TH St
Dental Service 160
Indianapolis, IN 46202-2803
Phone (317) 310-4294
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.