Healthcare Provider Details

I. General information

NPI: 1730090994
Provider Name (Legal Business Name): INDY NORTH DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 W 86TH STREET
INDIANAPOLIS IN
46268
US

IV. Provider business mailing address

171 MONON BLVD
CARMEL IN
46032-2347
US

V. Phone/Fax

Practice location:
  • Phone: 317-525-7398
  • Fax:
Mailing address:
  • Phone: 317-525-7398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: ANKIT PATEL
Title or Position: OWNER
Credential: DMD
Phone: 317-525-7398