Healthcare Provider Details
I. General information
NPI: 1821955303
Provider Name (Legal Business Name): JULIAN SHAMSAIE DDS DENTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3132 W SR 38
PENDLETON IN
46064
US
IV. Provider business mailing address
3132 W SR 38
PENDLETON IN
46064
US
V. Phone/Fax
- Phone: 765-778-7585
- Fax: 765-778-0795
- Phone: 765-778-7585
- Fax: 765-778-0795
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIAN
SHAMSAIE
Title or Position: DENTIST - PRACTICE OWNER
Credential: DDS
Phone: 812-230-1036