NPIMap

Organization Active NPI

Pebble Brook Dentistry LLC

  • General Practice Dentistry
  • Noblesville, IN
National Provider Identifier
1821273533
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010838A Issued in IN
Legal business name
PEBBLE BROOK DENTISTRY LLC
Practice address
5713 Pebble Village LN
Noblesville, IN 46062-7373
Phone
(317) 896-1515
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Dr. Chistopher Spohr, DDS
Title
President
Phone
(317) 896-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12010838A IN Primary

Addresses

Primary practice location

5713 Pebble Village LN
Noblesville, IN 46062-7373

Mailing address

5713 Pebble Village LN
Noblesville, IN 46062-7373
Phone (317) 896-1515

National Provider Directory

National Provider Directory

Locations

5713 Pebble Village Ln
Noblesville, IN 46062
Phone (317) 896-1515

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": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1821273533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 PEBBLE VILLAGE LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460627373",
            "telephone_number": "317-896-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5713 PEBBLE VILLAGE LN",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460627373",
            "telephone_number": "317-896-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEBBLE BROOK DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "SPOHR",
        "authorized_official_first_name": "CHISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-896-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010838A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.