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General NPI Number Information
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NPI Number | 1780597955
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Entity Type | Individual
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Provider Name | LWIN MOE AUNG BDS, MS, PHD
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Gender | Male
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 1121 W MICHIGAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5211
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Country | US
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Telephone | 317-274-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 1667 FETKE DR
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-8618
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Country | US
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Telephone | 269-313-5324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | LDR260377
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License Number State | IN
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