11530 E Washington Street Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

11530 E WASHINGTON STREET DENTAL, LLC

Doing business as

Indianapolis Emergency Dental Clinic

Practice address

11530 E Washington St
Indianapolis, IN 46229-2828

Phone

(317) 360-0569

NPI assigned

Jan 15, 2021

Last updated

Jan 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dean Stratman II

Title

Practice Administrator

Phone

(317) 360-0569

Specialties & licenses 1

Addresses

Other names 1

• Indianapolis Emergency Dental Clinic Doing business as

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1881283687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292828",
            "telephone_number": "317-360-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292828",
            "telephone_number": "317-360-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "11530 E WASHINGTON STREET DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "STRATMAN",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "317-360-0569",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indianapolis Emergency Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.