Healthcare Provider Details

I. General information

NPI: 1962256529
Provider Name (Legal Business Name): LAUREN ECKERT DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9126 TECHNOLOGY LN STE 100
FISHERS IN
46038-3094
US

IV. Provider business mailing address

9126 TECHNOLOGY LN STE 100
FISHERS IN
46038-3094
US

V. Phone/Fax

Practice location:
  • Phone: 317-598-9898
  • Fax: 317-596-9659
Mailing address:
  • Phone: 317-598-9898
  • Fax: 317-596-9659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number12015023A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: