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INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC NPI 1407809585


NPI Information

NPI: 1407809585
Provider Name: INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC

Other Name: INDIANA ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
10972 ALLISONVILLE RD
SUITE 110
FISHERS, IN
ZIP 46038
Phone: (317) 913-2363
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INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC 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. INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC NPI is 1407809585. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Indiana Oral And Maxillofacial Surgery Associates.

The provider's business location address is:

10972 ALLISONVILLE RD
SUITE 110
FISHERS, IN
ZIP 46038-637
Phone: (317) 913-2363
Fax: (317) 913-2370

The provider's authorized official is Keith Miller .
The authorized official title is Administrator and has the following contact phone number (317) 913-2363.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 4/14/2017.


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 SurgeryYes

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
1100059140MEDICAIDINDIANA

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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