Organization Active NPI

Affinity Family Dental LLC

Doing business as Affinity Family Dental

  • General Practice Dentistry
  • Shelbyville, IN
National Provider Identifier
1790496776
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AFFINITY FAMILY DENTAL LLC
Doing business as
Affinity Family Dental
Practice address
2158 Intelliplex Dr Ste 114
Shelbyville, IN 46176-8549
Phone
(317) 392-3231
NPI assigned
Dec 9, 2022
Last updated
Dec 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Srinivas Durshanapalli, DDS
Title
President
Phone
(217) 303-5955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2158 Intelliplex Dr Ste 114
Shelbyville, IN 46176-8549

Mailing address

2158 Intelliplex Dr Ste 114
Shelbyville, IN 46176-8549
Phone (317) 392-3231

Other names 1

  • Affinity Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2158 Intelliplex Dr
Ste 114
Shelbyville, IN 46176
Phone (317) 392-3231

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1790496776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 INTELLIPLEX DR STE 114",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768549",
            "telephone_number": "317-392-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 INTELLIPLEX DR STE 114",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768549",
            "telephone_number": "317-392-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "DURSHANAPALLI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-303-5955",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinity Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.