MEDICARE: GEIST ORAL & FACIAL SURGERY, PC

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	12008680A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134254170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEIST ORAL & FACIAL SURGERY, PC

Provider Business Mailing Address
First Line	:	8170 OAKLANDON RD
Second Line	:	STE. B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-9543
Country	:	US
Telephone Number	:	317-823-4260
Fax Number	:	317-823-4270

Provider Business Practice Location Address
First Line	:	8170 OAKLANDON RD
Second Line	:	STE. B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-9543
Country	:	US
Telephone Number	:	317-823-4260
Fax Number	:	317-823-4270

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER A BURNS
Credential	:	D.D.S.
Telephone Number	:	317-823-4260

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	05/01/2009

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