Healthcare Provider Details

I. General information

NPI: 1538086517
Provider Name (Legal Business Name): MITCHELL PARRISH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 N POST RD STE A
INDIANAPOLIS IN
46219-4245
US

IV. Provider business mailing address

1035 N POST RD STE A
INDIANAPOLIS IN
46219-4245
US

V. Phone/Fax

Practice location:
  • Phone: 317-897-6074
  • Fax:
Mailing address:
  • Phone: 317-897-6074
  • Fax: 317-897-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12015020A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: