=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407697626
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARIEL ELIZABETH ZALESIN DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2024
-----------------------------------------------------
Last Update Date | 01/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1828 E STATE ROAD 44
-----------------------------------------------------
City | SHELBYVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46176-5507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-604-5275
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 N SENATE AVE UNIT 651
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46204-1259
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-563-7872
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 12014456A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 019.036817
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------