DR. GARY L BRESLAUER (NPI# 1366553570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366553570 |
| Entity Type | Individual |
| Full Name | DR. GARY L BRESLAUER |
| Credential | DDS |
| Practice Address |
6117 N College Ave Indianapolis ID 46220 |
| Mailing Address |
6117 N College Ave Indianapolis IN 46220-2233 |
| Practice Telephone | 3172573368 |
| Practice Fax Number | 3172575909 |
| Mailing Telephone | 3172573368 |
| Mailing Fax Number | 3172575909 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 12007547A | Dental Providers |
| Street Address |
6117 N COLLEGE AVE |
| City | INDIANAPOLIS |
| State | ID |
| Zip Code | 46220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144676123 | Indiana Center for Surgical Arts | Dentist | 6117 N College Ave, Suite 4, Indianapolis, IN 46220-2233 | 2016-05-10 |
| 1073840393 | Broad Ripple Family Dental, LLC | Dentist | 6117 N College Ave, Indianapolis, IN 46220-2233 | 2009-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255168 | Know The Drill, LLC | Dentist | 6284 Rucker Road, Suite G, Indianapolis, IN 46220 | 2020-01-29 |
| 1902361017 | Stephanie Jean Tellus | Physical Therapist | 5620 Carvel Ave, Indianapolis, IN 46220 | 2019-02-02 |
| 1861972879 | Ashley M Pondexter | Counselor | 820 E 64th St, Indianapolis, IN 46220 | 2018-08-19 |
| 1649766403 | Amy Yonan | Social Worker | 3830 Rue Delacroix, Indianapolis, IN 46220 | 2018-07-05 |
| 1295226066 | Royal Comfort Home Care | In Home Supportive Care | 2804 55th Pl Ste K, Indianapolis, IN 46220 | 2018-05-28 |
| 1104322148 | Jessica Lynn Neidlinger | Counselor | 819 E 64th St Ste 220, Indianapolis, IN 46220 | 2018-03-30 |
| 1497273494 | Squareone Wellness | Nurse Practitioner | 5422 N Keystone Ave, Indianapolis, IN 46220 | 2017-08-30 |
| 1356866834 | Andrea Elaine Tennancour | Nurse Practitioner | My Mobile Md LLC, 7007 Graham Road Suite 215, Indianapolis, IN 46220 | 2017-08-07 |
| 1346762283 | Nicole Shields | Specialist/Technologist | 6020 Carvel Ave, 1234 Unit, Indianapolis, IN 46220 | 2017-07-12 |
| 1972033389 | Laurie Budlong-morse | Marriage & Family Therapist | 815 E 63rd Pl Ste 204, Indianapolis, IN 46220 | 2017-06-18 |
| Find all providers in zip 46220 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295878494 | Tonya Dawn Marks | Dental Assistant | 6516 Alder Ct, Indianapolis, IN 46268-4486 | 2007-02-15 |
| 1225526072 | Joselynn Stephens | Dental Assistant | 1481 W 10th St, Indianapolis, IN 46202-2803 | 2018-04-27 |
| 1568542868 | Amanda Kay Wiseman | Dental Assistant | 9443 E 38th St, Dental Clinic, Indianapolis, IN 46235-2132 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982022422 | Jamie Parker | Dental Assistant | 1312 S Ivy St, Apt D, Nampa, ID 83686-6029 | 2014-04-02 |
| 1992714489 | Bret C Davis | Dental Assistant | 788 Eastland Drive, Suite A, Twin Falls, ID 83301 | 2006-08-05 |
| 1639725286 | Kadeesh Mcnaught | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-09 |
| 1487200036 | Terrance Valdespino | Dental Assistant | 90 Hope Dr, Mountain Home Afb, ID 83648-1057 | 2019-08-09 |
| 1982259875 | David J Emert | Dental Assistant | 90 Hope Dr Bldg 6000, Mountain Home Afb, ID 83648-1062 | 2019-08-07 |
| 1700874567 | Evie L Gardipe | Dental Assistant | 1115 B St, Plummer, ID 83851-0388 | 2005-10-06 |
| 1942297924 | Michele L Ott | Dental Assistant | 1115 B Street, Plummer, ID 83851-0388 | 2005-10-04 |
| City | INDIANAPOLIS |
| Zip Code | 46220 |
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| 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.