Imran Dobouni
Individual provider Active NPI Dentist · Greensburg, IN
NPI 1669170668 · NPPES record last updated Jun 11, 2023
Key facts
- NPI
- 1669170668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12014133A (IN)
- Practice address
- 101 E 10TH St
Greensburg, IN 47240-8202 - Phone
- (317) 603-0660
- NPI assigned
- Feb 20, 2023
- 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 |
|---|---|---|---|
| 12014133A | IN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12014133A | IN | Yes |
Addresses
Primary practice location
101 E 10TH St
Greensburg, IN 47240-8202
Mailing address
10551 Greenway Dr
Fishers, IN 46037-9374
Phone (317) 603-0660
Other providers in Greensburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2023. 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.