SARA GHOLAM (NPI# 1194245225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194245225 |
| Entity Type | Individual |
| Full Name | SARA GHOLAM |
| Credential | DMD |
| Practice Address |
1121 W Michigan St Rm 280b Indianapolis IN 46202 |
| Mailing Address |
1121 W Michigan St Rm 280b Indianapolis IN 46202-5211 |
| Practice Telephone | 3172745348 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS042216 | PA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | LDR170182 | IN | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1121 W Michigan St Rm 280b, Indianapolis, IN 46202 | 3172745348 |
| Street Address |
1121 W MICHIGAN ST RM 280B |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801454889 | Richard Joseph Stuart IIi | Student in an Organized Health Care Education/Training Program | 1121 W Michigan St Rm 280b, Indianapolis, IN 46202-5211 | 2019-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
| 1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
| 1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
| 1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
| 1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
| 1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
| 1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
| Find all providers in zip 46202 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629443544 | Allison C Scully | Dentist | 1121 W Michigan Street Ds307b, Indianapolis, IN 46202-5186 | 2015-12-03 |
| 1346535010 | Scott D. Papineau | Dentist | 7725 S Emerson Ave, Indianapolis, IN 46237-8654 | 2011-06-10 |
| 1376837070 | Steele Pediatric Dentistry LLC | Dentist | 4509 Northeastern Ave, Indianapolis, IN 46239-1660 | 2011-05-31 |
| 1124151592 | Judith Renee Chin | Dentist | 1121 W Michigan St # Ds220, Indiana University School of Dentistry, Indianapolis, IN 46202-5211 | 2007-03-14 |
| 1437280526 | David Scott Morgan | Dentist | 8802 N Meridian St, Suite 101, Indianapolis, IN 46260-5318 | 2007-03-08 |
| 1700949724 | Sandersweddellpediatric Dentalspecialist | Dentist | 860 East 86th Street, Suite1, Indianapolis, IN 46240-6859 | 2006-12-19 |
| 1952477846 | Annette Tepner Farthing | Dentist | 7725 S Emerson Avenue, Indianapolis, IN 46237-8654 | 2006-11-24 |
| 1881769602 | James A. Weddell Dds,msd,pc | Dentist | 3737 North Meridian, Suite 100, Indianapolis, IN 46208-4357 | 2006-11-21 |
| 1811062664 | Kelli R Lucia | Dentist | 3737 North Meridian Street, Suite 100, Indianapolis, IN 46208-4357 | 2006-11-21 |
| 1124193974 | Swati Singh | Dentist | 9240 N Meridian St Ste 120, Indianapolis, IN 46260-1811 | 2006-11-21 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46202 |
Please comment or provide details below to improve the information on SARA GHOLAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.