Organization Active NPI

Mec Dental I, P.C.

  • General Practice Dentistry
  • Shelbyville, IN
National Provider Identifier
1811159700
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010045A Issued in IN
Legal business name
MEC DENTAL I, P.C.
Doing business as
Shelbyville Family Dental
Practice address
114 Lee Blvd
Suite E
Shelbyville, IN 46176-3403
Phone
(317) 398-6399
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Matthew Edward Church, D.M.D.
Title
Owner/President
Phone
(317) 336-6723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12010045A IN Primary

Addresses

Primary practice location

114 Lee Blvd
Suite E
Shelbyville, IN 46176-3403

Mailing address

114 Lee Blvd
Suite E
Shelbyville, IN 46176-3403
Phone (317) 398-6399

Other names 1

  • Shelbyville Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

114 Lee Blvd
Ste E
Shelbyville, IN 46176
Phone (317) 336-6723

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1811159700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 LEE BLVD",
            "address_2": "SUITE E",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461763403",
            "telephone_number": "317-398-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LEE BLVD",
            "address_2": "SUITE E",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461763403",
            "telephone_number": "317-398-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEC DENTAL I, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "317-336-6723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010045A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelbyville 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 Jul 1, 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.