Organization Active NPI

Mobile Dentists Management II, LLC

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1689781270
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MOBILE DENTISTS MANAGEMENT II, LLC
Practice address
133 W Market St
Suite 270
Indianapolis, IN 46204-2801
Phone
(888) 833-8441
Fax
(888) 330-4331
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Margo Yellin Woll, DDS
Title
Dental Director
Phone
(888) 833-8441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

133 W Market St
Suite 270
Indianapolis, IN 46204-2801

Mailing address

PO Box 250310
West Bloomfield, MI 48325-0310
Phone (888) 833-8441

Other identifiers 1

IdentifierTypeStateIssuer
200315370AMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1689781270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250310",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483250310",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MARKET ST",
            "address_2": "SUITE 270",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042801",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DENTISTS MANAGEMENT II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WOLL",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "YELLIN",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "888-833-8441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200315370A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.