EAST INDY DENTAL CARE, LLC (NPI# 1366742371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366742371 |
| Entity Type | Organization |
| Organization Name | EAST INDY DENTAL CARE, LLC |
| Practice Address |
6433 E Washington St Suite 105 Indianapolis IN 46219-6677 |
| Practice Telephone | 3173752273 |
| Mailing Telephone | 3173752273 |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-10-25 |
| Authorized Official Name | DR. MARK WARREN SANFORD (MEMBER) |
| Authorized Official Telephone | 3174915095 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12011298A | IN | Dental Providers |
| Street Address |
6433 E WASHINGTON ST SUITE 105 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46219-6677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093901480 | Southern Medical Corporation PC | Internal Medicine | 6433 E Washington St, Suite 125, Indianapolis, IN 46219-6677 | 2007-09-19 |
| 1497236814 | L.a.s.e.r. Project Inc | Case Management | 6433 E Washington St, Indianapolis, IN 46219-6677 | 2018-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571157 | Kara Kathryn Berning | Dietitian, Registered | 2040 N. Shadeland Ave, Suite 130, Indianapolis, IN 46219 | 2020-09-01 |
| 1780223750 | Erin Cannon | Specialist | 1543 N Post Rd, Indianapolis, IN 46219 | 2019-12-23 |
| 1073151239 | Tanicka Elizabeth Word | Behavior Technician | 6635 E 21st Street, West Building, Indianapolis, IN 46219 | 2019-12-18 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1336645985 | Lynell Westbrook Gates | Counselor | 1311 N Arlington Ave Ste 102, Indianapolis, IN 46219 | 2018-04-03 |
| 1861991689 | Comfort Dental LLC | Clinic/Center | 8151 E 21st St., Indianapolis, Indianapolis, IN 46219 | 2018-02-07 |
| 1467811570 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6701 E 21st St, Indianapolis, IN 46219 | 2016-02-17 |
| 1992197289 | Casey Baker | Physician Assistant | 1500 N Ritter Ave (medical Associates, LLP), Indianapolis, IN 46219 | 2015-02-24 |
| 1811398407 | Adam Romesser | Pharmacist | 8907 E. 10th St., Indianapolis, IN 46219 | 2014-09-15 |
| 1225448673 | Justin Stauffer | Pharmacist | 5903 E Pleasant Run Parkway North Dr, Indianapolis, IN 46219 | 2014-05-06 |
| Find all providers in zip 46219 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770194698 | Dental Professionals of In, P.C. | Dentist | 8570 Northwest Blvd, Indianapolis, IN 46278-1383 | 2020-08-13 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1932766508 | Brooke Nichole Scott | Dentist | 5501 E 71st St Ste 3, Indianapolis, IN 46220-3900 | 2019-05-20 |
| 1851875546 | Andrew David Power | Dentist | 5869 Lawton Loop East Drive, Indianapolis, IN 46216 | 2018-09-19 |
| 1639652126 | Gh Dental | Dentist | 6925 S Harding St Ste A, Indianapolis, IN 46217-4114 | 2018-09-11 |
| 1326533068 | Bryce Ashton Chambers | Dentist | 6010 W 86th St Ste 118, Indianapolis, IN 46278-1407 | 2018-06-26 |
| 1932694528 | Mfdc of Indiana, Inc | Dentist | 6225 W 56th St Ste 100, Indianapolis, IN 46254-0002 | 2018-06-26 |
| 1306331905 | Mfdc of Indiana, Inc | Dentist | 5935 S Emerson Ave Ste 200, Indianapolis, IN 46237-1975 | 2018-06-26 |
| 1376037853 | Decatur Family Dentistry LLC | Dentist | 5021 Kentucky Ave Ste G, Indianapolis, IN 46221-3650 | 2018-06-19 |
| 1215420252 | Wesley Kenn Burcham | Dentist | 1481 W 10th St # 160, Indianapolis, IN 46202 | 2018-06-13 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46219 |
Please comment or provide details below to improve the information on EAST INDY DENTAL CARE, LLC.
| 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.