Healthcare Provider Details

I. General information

NPI: 1538005822
Provider Name (Legal Business Name): MCDONALD ORTHODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3684 US-150 #1
FLOYDS KNOBS IN
47119
US

IV. Provider business mailing address

3684 US-150 #1
FLOYDS KNOBS IN
47119
US

V. Phone/Fax

Practice location:
  • Phone: 812-923-9839
  • Fax:
Mailing address:
  • Phone: 812-923-9839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEC HUNTER MCDONALD
Title or Position: ORTHODONTIST
Credential: DMD, MSD
Phone: 317-373-6446