Healthcare Provider Details

I. General information

NPI: 1699898395
Provider Name (Legal Business Name): MYCHEL MACAPAGAL VAIL DDS, MSD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10078 LANTERN RD
FISHERS IN
46037-9685
US

IV. Provider business mailing address

10078 LANTERN RD
FISHERS IN
46037-9685
US

V. Phone/Fax

Practice location:
  • Phone: 317-570-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number12009771
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: