EAST INDIANAPOLIS ORAL AND MAXILLOFACIAL SURGERY (NPI# 1942426341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942426341 |
| Entity Type | Organization |
| Organization Name | EAST INDIANAPOLIS ORAL AND MAXILLOFACIAL SURGERY |
| Other Organization Name | STEVEN C. GRAHAM, DDS, MATTHEW C. MOLL, DDS |
| Practice Address |
125 N Shortridge Rd Indianapolis IN 46219-4908 |
| Practice Telephone | 3173531320 |
| Practice Fax Number | 3173595243 |
| Mailing Telephone | 3173531320 |
| Mailing Fax Number | 3173595243 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MATTHEW C MOLL (OWNER) |
| Authorized Official Telephone | 3173531320 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Steven C. Graham, DDS, Matthew C. Moll, DDS | Doing Business As Name - Organization |
| Street Address |
125 N SHORTRIDGE RD |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46219-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689890030 | Matthew Charles Moll | Dentist | 125 N Shortridge Rd, Indianapolis, IN 46219-4908 | 2007-04-17 |
| 1124245451 | Steven Cromwell Graham | Dentist | 125 N Shortridge Rd, Indianapolis, IN 46219-4908 | 2007-04-19 |
| 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 | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063918746 | Robinpreet Singh Pannu | Dentist | 550 University Blvd Ste 3195, Indianapolis, IN 46202-5149 | 2018-04-02 |
| 1659752335 | Yusif Umar | Dentist | 550 University Blvd # Uh3145, Indianapolis, IN 46202-5149 | 2015-06-17 |
| 1154710267 | Lawrence G. Falender Dds PC | Dentist | 1320 N Post Rd, Indianapolis, IN 46219-4210 | 2015-01-13 |
| 1144668989 | Timothy William Surber | Dentist | 5701 Brownstone Dr, Indianapolis, IN 46220-5851 | 2013-06-13 |
| 1396189387 | Intp Dental PC | Dentist | 8555 River Rd Ste 180, Indianapolis, IN 46240-4311 | 2013-04-22 |
| 1932440054 | John Joseph Schier Jr. | Dentist | 3021 E 98th St Ste 250, Indianapolis, IN 46280-2908 | 2013-03-14 |
| 1962766444 | Denise A Flanagan Dds PC | Dentist | 8240 Naab Rd Ste 355, Indianapolis, IN 46260-1987 | 2012-06-28 |
| 1417219056 | Ehlie Bruno | Dentist | 550 University Blvd Fl 3, Indiana University Medical Center, Omfs, Indianapolis, IN 46202-5149 | 2012-06-11 |
| 1881951622 | Patrick S Kelly | Dentist | 9860 Westpoint Dr Ste 100, Indianapolis, IN 46256-3398 | 2012-04-18 |
| 1184919250 | Ross Tyler Freeman | Dentist | 1050 Wishard Blvd, Rg-4201, Indianapolis, IN 46202 | 2011-06-16 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46219 |
Please comment or provide details below to improve the information on EAST INDIANAPOLIS ORAL AND MAXILLOFACIAL SURGERY.
| 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.