Healthcare Provider Details

I. General information

NPI: 1114481363
Provider Name (Legal Business Name): BIGGS-HANSEN ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 N MERIDIAN ST STE 301
INDIANAPOLIS IN
46260-1825
US

IV. Provider business mailing address

9333 N MERIDIAN ST STE 301
INDIANAPOLIS IN
46260-1825
US

V. Phone/Fax

Practice location:
  • Phone: 317-846-1455
  • Fax: 317-843-0626
Mailing address:
  • Phone: 317-846-1455
  • Fax: 317-843-0626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY C BIGGS
Title or Position: OWNER/ORTHODONTIST
Credential: DDS, MS
Phone: 317-846-1455