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IMMEDIADENT OF INDIANA PC NPI 1194193078


NPI Information

NPI: 1194193078
Provider Name: IMMEDIADENT OF INDIANA, PC

Doing Business As: IMMEDIADENT

Classification: Dentist - 122300000X
Entity Type: Organization
Address:
1160 E LEWIS AND CLARK PKWY
CLARKSVILLE, IN
ZIP 47129
Phone: (812) 284-4040
Get Directions

IMMEDIADENT OF INDIANA, PC is a dentist in Clarksville, IN. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. IMMEDIADENT OF INDIANA, PC NPI is 1194193078. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Immediadent.

The provider's business location address is:

1160 E LEWIS AND CLARK PKWY
CLARKSVILLE, IN
ZIP 47129-735
Phone: (812) 284-4040
Fax: (913) 800-6967

The provider's authorized official is Amy Wheeler .
The authorized official title is Credentialing Coordinator and has the following contact phone number (913) 800-6952.

The enumeration date for this NPI number is 9/9/2015 and was last updated on 9/9/2015.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentist12010746AINDIANAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200377170MEDICAIDINDIANA

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: 5/5/2024

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