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Contact Information

INDY EAST SMILES YOUTH DENTISTRY LLC
5430 EAST WASHINGTON STREET
SUITE 101
INDIANAPOLIS, IN46219
 Phone: 317-322-1840
 Fax: 615-986-1705
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for INDY EAST SMILES YOUTH DENTISTRY LLC · (Female)

NPI # 1013952696
Status Active
Credentials
Entity Individual
Enumeration date 06/18/2006
Last updated 06/24/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 200361860A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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