MEDICARE: MERIDIAN STREET PERIODONTICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	12010349A	IN

General Provider Information

NPI Number	:	1518470897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN STREET PERIODONTICS, LLC

Provider Business Mailing Address
First Line	:	8037 SARGENT RDG
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1848
Country	:	US
Telephone Number	:	317-574-0600
Fax Number	:	317-574-0606

Provider Business Practice Location Address
First Line	:	8801 N MERIDIAN ST STE 103
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2353
Country	:	US
Telephone Number	:	317-574-0600
Fax Number	:	317-574-0606

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ASHLEY THURMAN
Credential	:	EFDA
Telephone Number	:	317-842-8453

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	11/09/2017

Similar Medicare Providers

1164428660 — DR. DAVID GERSTEIN M.D.
Practice Location Address:

8801 N MERIDIAN ST , STE 107
INDIANAPOLIS, IN
46260-2353

Practice Phone: 317-848-3408
Practice Fax:

1194980391 — DR. ADAM B CHRISTMAN DDS MSD
Practice Location Address:

8801 N MERIDIAN ST STE 103
INDIANAPOLIS, IN
46260-2353

Practice Phone: 317-574-0600
Practice Fax:

1104576123 — CRAIG SHOUSE DPM PC
Practice Location Address:

8801 N MERIDIAN ST STE 106
INDIANAPOLIS, IN
46260-2353

Practice Phone: 317-299-2644
Practice Fax: 317-328-8914

1588342372 — DR. KENNEDY FAYE HOSTETLER PHARMD
Practice Location Address:

8801 N MERIDIAN ST STE 108
INDIANAPOLIS, IN
46260-2353

Practice Phone: 317-846-6654
Practice Fax: 317-846-3038

1285470351 — BRIGHTER DAYS PERSONAL SERVICES, LLC
Practice Location Address:

8801 N MERIDIAN ST STE 100
INDIANAPOLIS, IN
46260-2353

Practice Phone: 463-710-6595
Practice Fax: 317-449-8321

1699633677 — NAOMI MARIE JORDAN
Practice Location Address:

4819 ROUND LAKE RD APT G
INDIANAPOLIS, IN
46205-2353

Practice Phone: 463-312-1997
Practice Fax:

Directions to “MERIDIAN STREET PERIODONTICS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.