Teverbaugh4 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011392A Issued in IN

Legal business name

TEVERBAUGH4 LLC

Practice address

10967 Allisonville Rd
Suite 200
Fishers, IN 46038-2632

Phone

(317) 572-8626

NPI assigned

Mar 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Diana TeverbaughNPI 1043542210

Title

Dentist

Phone

(317) 572-8626

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Teverbaugh Dental Doing business as

Locations

Practitioners 1

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

• Diana Teverbaugh, DDS

  • Dentist
  • Fishers, IN
  • NPI 1043542210
  NPD (past) Authorized official

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1932441847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10967 ALLISONVILLE RD",
            "address_2": "SUITE 200",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382632",
            "telephone_number": "317-572-8626",
            "fax_number": "317-284-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 ALLISONVILLE RD",
            "address_2": "SUITE 200",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382632",
            "telephone_number": "317-572-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEVERBAUGH4 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "TEVERBAUGH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "317-572-8626",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011392A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009779108",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teverbaugh Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Telacare Health Solutions, LLC
• Matthew William Tellman, M.D.
• Giuliana Teoba-Flores
• Huicong Teshima, MD
• Diana Teverbaugh, DDS
• Darshini Thambiah
• Glynnis L Thatch, NP-C
• The Awe Center
• The Burrow Chiropractic LLC
• The Health and Hospital Corporation of Marion County

• General Practice Dentistry in Fishers, IN
• Providers in Fishers, 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 Jun 24, 2013; 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.