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FISHERS ORAL & MAXILLOFACIAL SURGERY NPI 1174534515


NPI Information

NPI: 1174534515
Provider Name: FISHERS ORAL & MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
9126 TECHNOLOGY LN
STE 300
FISHERS, IN
ZIP 46038
Phone: (317) 849-3667
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FISHERS ORAL & MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Fishers, IN. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. FISHERS ORAL & MAXILLOFACIAL SURGERY NPI is 1174534515. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9126 TECHNOLOGY LN
STE 300
FISHERS, IN
ZIP 46038-064
Phone: (317) 849-3667
Fax: (317) 849-3668

The provider's authorized official is Michael D Bennett .
The authorized official title is President Surgeon and has the following contact phone number (317) 849-3667.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 10/29/2012.


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
11223S0112XDentistOral and Maxillofacial Surgery12007758INDIANAYes

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
1OTH000MEDICARE UPIN

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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