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General NPI Number Information
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NPI Number | 1346118163
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Entity Type | Organization
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Legal Business Name | BDD CFAD PC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 8325 S EMERSON AVE STE A1
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8559
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Country | US
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Telephone | 317-859-6768
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Fax |
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Provider Business Mailing Address
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Address Line | 333 W 1ST ST
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City | ELMHURST
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State | IL
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Zip | 60126-2641
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | STEPHANIE MOORE
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Credential |
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Telephone | 832-704-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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