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Contact Information

INDY WEST SMILES YOUTH DENTISTRY, LLC
2802 LAFAYETTE ROAD
SUITE 33
INDIANAPOLIS, IN46222
 Phone: 317-925-2810
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for INDY WEST SMILES YOUTH DENTISTRY, LLC

NPI Number 1134164445
LBN Legal business name INDY WEST SMILES YOUTH DENTISTRY, LLC
Authorized official HELEN PETERSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/19/2006
Last updated 07/01/2019 - About 7 years ago
Identifiers
IN Medicaid 200434530A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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