Healthcare Provider Details

I. General information

NPI: 1124436498
Provider Name (Legal Business Name): CARINGSMILES 4U2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 MICHIGAN RD
INDIANAPOLIS IN
46268-1915
US

IV. Provider business mailing address

4615 LAFAYETTE RD SUITE B
INDIANAPOLIS IN
46254-2035
US

V. Phone/Fax

Practice location:
  • Phone: 317-968-9700
  • Fax: 317-968-9701
Mailing address:
  • Phone: 317-968-9700
  • Fax: 317-968-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12011023A
License Number StateIN

VIII. Authorized Official

Name: JUANITA R TAYLOR
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 317-968-9700