Center for Implant Denistry and Periodontics, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12010349A Issued in IN

Legal business name

CENTER FOR IMPLANT DENISTRY AND PERIODONTICS, LLC

Doing business as

Implant Dentistry and Periodontics

Practice address

9885 E 116TH St Ste 300
Fishers, IN 46037-9242

Phone

(317) 842-2273

Fax

(317) 842-7911

NPI assigned

Nov 9, 2017

Organization subpart

No

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

Authorized official

Name

Ashley Thurman, EFDA

Title

Office Manager

Phone

(317) 842-8453

Specialties & licenses 1

Addresses

Other names 1

• Implant Dentistry and Periodontics Doing business as

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1952814238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8037 SARGENT RDG",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561848",
            "telephone_number": "317-842-2273",
            "fax_number": "317-842-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9885 E 116TH ST STE 300",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379242",
            "telephone_number": "317-842-2273",
            "fax_number": "317-842-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR IMPLANT DENISTRY AND PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "THURMAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-842-8453",
        "authorized_official_credential": "EFDA"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12010349A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Implant Dentistry and Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodontics in Fishers, IN
• Providers in Fishers, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.