Healthcare Provider Details

I. General information

NPI: 1164133377
Provider Name (Legal Business Name): JAMES VOLOVIC DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9602 E WASHINGTON ST STE B
INDIANAPOLIS IN
46229-3060
US

IV. Provider business mailing address

990 FAWN VIEW DR
CARMEL IN
46032-7763
US

V. Phone/Fax

Practice location:
  • Phone: 317-898-7645
  • Fax:
Mailing address:
  • Phone: 717-424-2524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number12013590A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12013590A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: