Park Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12011836A Issued in IN

Legal business name

PARK PEDIATRIC DENTISTRY LLC

Practice address

1700 W Smith Valley Rd
Suite B1
Greenwood, IN 46142-1599

Phone

(317) 627-1755

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Lesa Allison, D.D.S., M.S.D.NPI 1720342876

Title

Owner, Managing Member

Phone

(317) 627-1755

Specialties & licenses 1

Addresses

Practitioners 1

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

• Lesa M Allison, D.D.S.

  • Dentist
  • Indianapolis, IN
  • NPI 1720342876
  NPD (past) Authorized official

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1730610833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441143",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462441143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W SMITH VALLEY RD",
            "address_2": "SUITE B1",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421599",
            "telephone_number": "317-627-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "LESA",
        "authorized_official_title_or_position": "OWNER, MANAGING MEMBER",
        "authorized_official_telephone_number": "317-627-1755",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12011836A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Blaire Parent, M.D.
• Shivani Parikshak, MD
• Paris Counseling LLC
• Jeff Dwayne Paris, PTA
• Randi Lynn Turner Paris, LCSW
• Jennifer Lee Parker, OTR
• Julie Marie Parker
• David Scot Parks, MD
• Amy Marie Parr, RBT
• Lauren Parr

• Pediatric Dentistry in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.