Great Lakes Family Dental Group-Indianapolis

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREAT LAKES FAMILY DENTAL GROUP-INDIANAPOLIS

Practice address

7465 E 82ND St
Indianapolis, IN 46256-1459

Phone

(317) 841-1111

NPI assigned

Nov 16, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia J Hart

Title

Corporate Manager

Phone

(317) 841-1111

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Family Dental Group-Indianapolis 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.

• George E Kirtley, DDS

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1790803393
  NPD (past)

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1982078853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7465 E 82ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561459",
            "telephone_number": "317-841-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7465 E 82ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561459",
            "telephone_number": "317-841-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FAMILY DENTAL GROUP-INDIANAPOLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "317-841-1111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Family Dental Group-Indianapolis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole M Grdinic
• Great Care Home Health, Inc.
• Great Direct Care Inc
• Great Hearts Home Care
• Great Lakes Caring Hospice C in, LLC
• Great Lengths Home Care, LLC
• Great Provider Health Services
• Great Smile Dental PC
• Greater Opportunity Development and Services Corporation
• Greater Opportunity Development and Services L.L.C

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.