Dental Services of Indiana, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL SERVICES OF INDIANA, P.C.

Practice address

4960 S Emerson Ave
Indianapolis, IN 46203-5937

Phone

(317) 324-4333

Fax

(866) 591-0604

NPI assigned

Mar 21, 2017

Organization subpart

Yes

Parent organization

DENTAL SERVICES OF INDIANA, P.C.As reported in NPPES

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

Authorized official

Name

Monica L Long

Title

Manager of Provider Credentialing

Phone

(913) 428-1686

Specialties & licenses 1

Addresses

Other names 1

• ImmediaDent Doing business as

Tax ID family

Dental Services of Indiana PC4 organizations share this tax ID, including this one

Part of

Dental Services of Indiana PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Dental Services of Indiana, P.C.

  • Dentist
  • Merrillville, IN
  • NPI 1144746314
  NPD tax ID
• Dental Services of Indiana, P.C.

  • Dentist
  • Schererville, IN
  • NPI 1669908885
  NPD tax ID
• Dental Services of Indiana, P.C.

  • Dentist
  • Schererville, IN
  • NPI 1760913958
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Dental Services of Indiana, P.C.

  • Dentist
  • Schererville, IN
  • NPI 1669908885
  NPPES parent name

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1982135174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11568",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074268",
            "telephone_number": "913-428-1686",
            "fax_number": "866-591-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462035937",
            "telephone_number": "317-324-4333",
            "fax_number": "866-591-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF INDIANA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL SERVICES OF INDIANA, P.C.",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER OF PROVIDER CREDENTIALING",
        "authorized_official_telephone_number": "913-428-1686"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ImmediaDent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dental Professionals of Indiana, P.C.
• Dental Professionals of Indiana, P.C.
• Dental Professionals of Indiana, P.C.
• Dental Professionals of Indiana, P.C.
• Dental Professionals of Indiana, P.C.
• Dental Sleep Medicine of Indiana
• Dental Sleep Medicine of Indiana Corporation
• Francis Casey Dentino, DDS
• Dentistry by DMK, LLC
• Dentistry of Indiana, Inc.

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, 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 May 1, 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.