Healthcare Provider Details

I. General information

NPI: 1073381745
Provider Name (Legal Business Name): ROSS T. BIGGERSTAFF, D.D.S., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 E 98TH ST STE 130
CARMEL IN
46280-2006
US

IV. Provider business mailing address

3105 E 98TH ST STE 130
CARMEL IN
46280-2006
US

V. Phone/Fax

Practice location:
  • Phone: 317-569-9977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: ROSS BIGGERSTAFF
Title or Position: DENTIST / OWNER
Credential: DDS, MSD
Phone: 317-507-0459