Healthcare Provider Details

I. General information

NPI: 1295060358
Provider Name (Legal Business Name): DENTAL SLEEP MEDICINE OF INDIANA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 CASTLE CREEK PARKWAY NORTH DR
INDIANAPOLIS IN
46250-4304
US

IV. Provider business mailing address

5625 CASTLE CREEK PARKWAY NORTH DR
INDIANAPOLIS IN
46250-4304
US

V. Phone/Fax

Practice location:
  • Phone: 317-585-0008
  • Fax:
Mailing address:
  • Phone: 317-585-0008
  • Fax: 317-585-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD ALLEN SMITH
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 317-253-9111