NPIMap

Organization Active NPI

Great Smile Dental PC

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1861666851
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12010607A Issued in IN
Legal business name
GREAT SMILE DENTAL PC
Practice address
4200 S East St
Indianapolis, IN 46227-1534
Phone
(317) 787-1320
NPI assigned
Apr 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Authorized official

Name
Dr. Shawn Cabbell, DDS
Title
Officer
Phone
(317) 361-2745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12010607A IN Primary

Addresses

Primary practice location

4200 S East St
Indianapolis, IN 46227-1534

Mailing address

4200 S East St
Indianapolis, IN 46227-1534
Phone (317) 787-1320

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1861666851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271534",
            "telephone_number": "317-787-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271534",
            "telephone_number": "317-787-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "CABBELL",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "317-361-2745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010607A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

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