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General NPI Number Information
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NPI Number | 1306817622
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Entity Type | Organization
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Legal Business Name | DCP OF INDIANA (LAFAYETTE SQUARE) PC
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4050 LAFAYETTE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-2527
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Country | US
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Telephone | 317-328-5905
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Fax | 317-328-8533
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Provider Business Mailing Address
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Address Line | PO BOX 64-3011
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City | CINCINNATI
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State | OH
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Zip | 45264-0001
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Country | US
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Telephone | 317-328-5905
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Fax | 317-328-8533
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | DR. ED MECKLER
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Credential | D.D.S.
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Telephone | 800-487-4867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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