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General NPI Number Information
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NPI Number | 1790646859
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Entity Type | Organization
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Legal Business Name | GEIST ORTHO GROUP, LLC.
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 8418 E 116TH ST
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City | FISHERS
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State | IN
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Zip | 46038-1506
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Country | US
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Telephone | 317-585-7491
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 OAKLANDON RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46236-9543
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Country | US
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Telephone | 317-823-8338
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Fax | 317-823-8420
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Authorized Official
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Title or Position | ORTHODONTIST / OWNER
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Name | DR. JULIAN E. DAVILA
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Credential | DMD, MS.
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Telephone | 317-507-9820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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