Healthcare Provider Details

I. General information

NPI: 1053231472
Provider Name (Legal Business Name): PIRTPAL SINGH BENIPAL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8028 S EMERSON AVE STE A
INDIANAPOLIS IN
46237-9301
US

IV. Provider business mailing address

2653 FALCON DR
GREENWOOD IN
46143-3406
US

V. Phone/Fax

Practice location:
  • Phone: 317-648-5527
  • Fax:
Mailing address:
  • Phone: 317-648-5527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12015100A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: