Healthcare Provider Details

I. General information

NPI: 1053227074
Provider Name (Legal Business Name): BENGINA DANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 S EMERSON AVE STE 100
INDIANAPOLIS IN
46237-1972
US

IV. Provider business mailing address

7233 DARLEY LN
INDIANAPOLIS IN
46259-2505
US

V. Phone/Fax

Practice location:
  • Phone: 317-661-1060
  • Fax:
Mailing address:
  • Phone: 516-813-5463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: