Healthcare Provider Details

I. General information

NPI: 1396908422
Provider Name (Legal Business Name): JAN SLAPNICKA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD STE 3195
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

1050 WISHARD BLVD RG 4201
INDIANAPOLIS IN
46202-2872
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-7433
  • Fax:
Mailing address:
  • Phone: 317-274-5315
  • Fax: 317-278-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number12011702A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: