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INDIANA UNIVERSITY RADIOLOGY ASSOCIATES INC NPI 1376889568


NPI Information

NPI: 1376889568
Provider Name: INDIANA UNIVERSITY RADIOLOGY ASSOCIATES INC
Classification: Dentist - 1223X0008X
Entity Type: Organization

Specialization: Oral and Maxillofacial Radiology

Address:
250 N SHADELAND AVE
STE 200
INDIANAPOLIS, IN
ZIP 46219
Phone: (317) 962-4836
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INDIANA UNIVERSITY RADIOLOGY ASSOCIATES INC is an oral and maxillofacial radiology dentist in Indianapolis, IN. The provider is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. INDIANA UNIVERSITY RADIOLOGY ASSOCIATES INC NPI is 1376889568. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

250 N SHADELAND AVE
STE 200
INDIANAPOLIS, IN
ZIP 46219-959
Phone: (317) 962-4836
Fax: (317) 962-4391

The provider's authorized official is Randall J Luckey .
The authorized official title is Secretary, Treasurer and has the following contact phone number (317) 472-4565.

The enumeration date for this NPI number is 12/17/2012 and was last updated on 6/5/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist12010577INDIANANo
21223X0008XDentistOral and Maxillofacial Radiology12010577INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1201129790MEDICAIDINDIANA
2959090MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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