Midwest Dental Specialists, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MIDWEST DENTAL SPECIALISTS, LLC

Practice address

1650 W Oak St Ste 206
Zionsville, IN 46077-3836

Phone

(317) 349-0419

Fax

(317) 342-4149

NPI assigned

Jan 17, 2024

Organization subpart

No

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

Authorized official

Name

Gloria Royer, AS

Title

Office / HR Manager

Phone

(765) 447-9319

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1922869015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST STE 303",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042893",
            "telephone_number": "765-447-9319",
            "fax_number": "765-447-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W OAK ST STE 206",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460773836",
            "telephone_number": "317-349-0419",
            "fax_number": "317-342-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DENTAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "ROYER",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "OFFICE / HR MANAGER",
        "authorized_official_telephone_number": "765-447-9319",
        "authorized_official_credential": "AS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Zionsville, IN
• Providers in Zionsville, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.