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General NPI Number Information
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NPI Number | 1558184127
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Entity Type | Organization
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Legal Business Name | GLOBAL SMILES DENTAL 13 LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 3269 W 86TH ST STE A2
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-3822
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Country | US
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Telephone | 317-830-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 10706 E US HIGHWAY 36
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City | AVON
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State | IN
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Zip | 46123-7982
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Country | US
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Telephone | 317-956-5035
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING ASSOCIATE
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Name | TIA WHITE
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Credential |
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Telephone | 317-830-0404
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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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