JACK E NICEWANDER (NPI# 1689067928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689067928 |
| Entity Type | Organization |
| Organization Name | JACK E NICEWANDER |
| Practice Address |
5511 E 82nd St Ste F Indianapolis IN 46250-4698 |
| Practice Telephone | 3178421903 |
| Practice Fax Number | 3178498054 |
| Mailing Telephone | 3178421903 |
| Mailing Fax Number | 3178498054 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-04-06 |
| Authorized Official Name | DR. JACK E NICEWANDER (OWNER) |
| Authorized Official Telephone | 3178421903 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
12007501A | IN | Ambulatory Health Care Facilities |
| Street Address |
5511 E 82ND ST STE F |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46250-4698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659443802 | Jack E. Nicewander | Dentist | 5511 E 82nd St, Suite F, Indianapolis, IN 46250-4698 | 2006-11-14 |
| 1932563970 | Great Care Home Health, Inc. | Home Health | 5511 E 82nd St, Ste C, Indianapolis, IN 46250-4515 | 2016-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
| 1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
| 1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
| 1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
| 1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
| 1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
| Find all providers in zip 46250 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720147 | Ms Vibbert Dds PC | Clinic/Center | 7301 Georgetown Rd Ste 113, Indianapolis, IN 46268-4157 | 2020-11-05 |
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1033746136 | Jillian C. Brady, Dds, LLC | Clinic/Center | 5150 E Stop 11 Rd Ste 11, Indianapolis, IN 46237-8629 | 2020-03-26 |
| 1356813935 | Red Hat Neighborhood Dentist | Clinic/Center | 5719 Lawton Loop East Dr Ste 2, Indianapolis, IN 46216-2322 | 2018-12-20 |
| 1336618503 | Kim & Au-yeung Dentistry, P.C. | Clinic/Center | 8354 Little Eagle Ct Ste A, Indianapolis, IN 46234-3822 | 2018-11-17 |
| 1033686142 | Red Bird Dental LLC | Clinic/Center | 839 S Delaware St, Indianapolis, IN 46225-1782 | 2018-10-26 |
| 1497239297 | Dennis J. Heritier Dds P.C. | Clinic/Center | 6284 Rucker Rd Ste G, Indianapolis, IN 46220-4851 | 2018-09-18 |
| 1689165672 | Xu Family Dental, LLC | Clinic/Center | 828 Fort Wayne Ave, Indianapolis, IN 46204-1309 | 2018-05-24 |
| 1205332327 | Monroe County Family Dental and Implant Center | Clinic/Center | 401 N Senate Ave Unit 648, Indianapolis, IN 46204-1259 | 2018-04-05 |
| 1861991689 | Comfort Dental LLC | Clinic/Center | 8151 E 21st St., Indianapolis, Indianapolis, IN 46219 | 2018-02-07 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46250 |
Please comment or provide details below to improve the information on JACK E NICEWANDER.
| 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.