NPI 1306817622 · live from the CMS NPI Registry
Dcp Of Indiana (Lafayette Square) PC
Dentist, Orthodontics and Dentofacial Orthopedics in Indianapolis, IN. National Provider Identifier 1306817622, active.
NPI record
| NPI | 1306817622 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 4050 Lafayette Rd, Indianapolis, IN 46254 |
| Practice phone | 317-328-5905 |
| Mailing address | Po Box 64-3011, Cincinnati, OH 45264 |
| Enumerated | January 27, 2006 |
| Last updated | September 11, 2025 |
| Authorized official | Ed Meckler, Chairman Of The Board |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | — |
| Dentist, Endodontics | 1223E0200X | — |
| Dentist, General Practice | 1223G0001X | — |
| Dentist, Pediatric Dentistry | 1223P0221X | — |
| Dentist, Periodontics | 1223P0300X | — |
| Dentist, Prosthodontics | 1223P0700X | — |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.