Olive Branch Dental-2 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OLIVE BRANCH DENTAL-2 LLC

Practice address

2459 W Jonathan Moore Pike
Columbus, IN 47201-9206

Phone

(812) 516-5777

Fax

(812) 531-1177

NPI assigned

Jan 7, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Srinivas Durshanapali, DDS

Title

President

Phone

(217) 303-5955

Specialties & licenses 1

Addresses

Other names 1

• Olive Branch Dental Columbus Doing business as

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1972264398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2459 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472019206",
            "telephone_number": "812-516-5777",
            "fax_number": "812-531-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2459 W JONATHAN MOORE PIKE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472019206",
            "telephone_number": "812-516-5777",
            "fax_number": "812-531-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH DENTAL-2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "DURSHANAPALI",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-303-5955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olive Branch Dental Columbus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adriana Ojeda
• Dominique Lise Okpiri, PHARMD,RPH
• Jakub R Olczyk, DDS
• Olinger and Larkin PTR
• Natalie J Olinger, O.D.
• Sandra Minnick Oliverio, MS, RD, CD
• Bertha A Olmeda
• Gazzie Olmstead
• Ansgar Steven Olsen, DPM
• Larry Dean Olson

• General Practice Dentistry in Columbus, IN
• Providers in Columbus, 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 7, 2022; 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.