Healthcare Provider Details
I. General information
NPI: 1053257923
Provider Name (Legal Business Name): ADS OF IN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2441 STATE ST
NEW ALBANY IN
47150-4962
US
IV. Provider business mailing address
PO BOX 437169
LOUISVILLE KY
40253-7169
US
V. Phone/Fax
- Phone: 502-254-8532
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
REIBEL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 502-254-8500