East Washington Street Dental Indy, in, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EAST WASHINGTON STREET DENTAL INDY, IN, PC

Practice address

9972 E Washington St
Indianapolis, IN 46229-3040

Phone

(770) 916-5036

NPI assigned

Jun 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Dale Mayfield, DMD

Title

President

Phone

(770) 916-5036

Specialties & licenses 4

Addresses

Other names 1

• Pippin Dental Doing business as

Locations

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1992299689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676407",
            "telephone_number": "770-916-5036",
            "fax_number": "678-285-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9972 E WASHINGTON ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462293040",
            "telephone_number": "770-916-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST WASHINGTON STREET DENTAL INDY, IN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-916-5036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pippin Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Indy Dental Care, LLC
• East Side Rheumatology
• East Street Spine & Rehab, Inc.
• East Washington Chiropractic PC
• East Washington Pharmacy LLC
• East Wind Therapy
• Kim Lynn East, MSW LCSW
• Kristen East
• Tajah Latrice Joi East
• Babbie Brae Easter, OTR

• 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 Jun 18, 2018; 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.