NPI 1700857026 · live from the CMS NPI Registry
Dcp Of Indiana (Castleton Square), P.C.
Dentist, General Practice in Indianapolis, IN. National Provider Identifier 1700857026, active.
NPI record
| NPI | 1700857026 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 4025 E 82nd St Ste 104, Indianapolis, IN 46250 |
| Practice phone | 317-913-0480 |
| Mailing address | 7160 Dallas Pkwy Ste 400, Plano, TX 75024 |
| Enumerated | January 27, 2006 |
| Last updated | March 19, 2018 |
| Authorized official | Rachel Nittinger, Credentialing Manager |
| Other names | Dentalworks Of Clearwater |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | — |
| Dentist, Endodontics | 1223E0200X | — |
| Dentist, Pediatric Dentistry | 1223P0221X | — |
| Dentist, Periodontics | 1223P0300X | — |
| Dentist, Prosthodontics | 1223P0700X | — |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — |
| Dentist, General Practice primary | 1223G0001X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.