MEDICARE: DR. SARAH ELIZABETH DOBSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12014414A	IN

General Provider Information

NPI Number	:	1033959192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH ELIZABETH DOBSON DDS

Provider Business Mailing Address
First Line	:	6941 VISTAMERE WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-4156
Country	:	US
Telephone Number	:	804-591-9924
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 W MICHIGAN ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5211
Country	:	US
Telephone Number	:	317-274-7433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	05/28/2024

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