Healthcare Provider Details

I. General information

NPI: 1437282878
Provider Name (Legal Business Name): CHERYL KRUSHINSKI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 W MICHIGAN ST
INDIANAPOLIS IN
46202-5211
US

IV. Provider business mailing address

6915 WINDJAMMER DR
BROWNSBURG IN
46112-8240
US

V. Phone/Fax

Practice location:
  • Phone: 317-278-7247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12008916
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: