Rebecca P. Bolon DDS MSD PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

REBECCA P. BOLON DDS MSD PC

Doing business as

Rebecca P. Bolon DDS MSD PC

Practice address

9311 N Meridian St Ste 200
Indianapolis, IN 46260-1865

Phone

(317) 846-6107

NPI assigned

Oct 14, 2022

Last updated

Oct 14, 2022By 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

David Padrick

Title

Office Manager

Phone

(317) 374-3829

Specialties & licenses 1

Addresses

Other names 1

• Rebecca P. Bolon DDS MSD PC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca P Bolon, DDS MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Indianapolis, IN
  • NPI 1497869614
  NPD

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1699491316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9311 N MERIDIAN ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9311 N MERIDIAN ST STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601865",
            "telephone_number": "317-846-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA P. BOLON DDS MSD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "PADRICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-374-3829"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebecca P. Bolon DDS MSD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Gilbert Reaves, LMHC
• Vincent Reaves Jr.
• Brittany A Reavis, OTD, OTR/L
• Leah Rebarber
• Elmar Rebato
• Rebecca Waletich LCSW LLC (Transformations Counseling Services)
• Madison Taylor Rebholz, PA-C
• Jason Andrew Rebic, CSFA
• Rebecca Leed Rebman, PA-C
• Natalia Reborido Campoy, MD

• Dental Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.