Healthcare Provider Details

I. General information

NPI: 1225048572
Provider Name (Legal Business Name): JULIA ALEX SHALIT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 W MICHIGAN ST
INDIANAPOLIS IN
46202-5186
US

IV. Provider business mailing address

9124 TECHNOLOGY LN STE 200
FISHERS IN
46038-2839
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-7433
  • Fax:
Mailing address:
  • Phone: 317-849-3444
  • Fax: 317-849-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12010761A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: