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Contact Information

ADVANCED DENTAL
15285 W 101ST AVE
SUITE H
DYER, IN46311-3035
 Phone: 219-365-5420
 Fax: 219-365-5448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL

NPI Number 1528118148
LBN Legal business name ADVANCED DENTAL
Authorized official MARIE GAMBETTA - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 01/12/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
IN License # 12010023A
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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