Healthcare Provider Details

I. General information

NPI: 1760469936
Provider Name (Legal Business Name): DENNIS L PIPPENGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 WESTFIELD RD SUITE B
NOBLESVILLE IN
46060-1425
US

IV. Provider business mailing address

PO BOX 869
NOBLESVILLE IN
46061-0869
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-9400
  • Fax: 317-776-2192
Mailing address:
  • Phone: 317-770-6900
  • Fax: 317-770-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01025686
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: