MEDICARE: DR. MICHAEL G KAPP D.D.S.

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	12009299A	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	:	1215977368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL G KAPP D.D.S.

Provider Business Mailing Address
First Line	:	10972 ALLISONVILLE RD
Second Line	:	SUITE 110
City	:	FISHERS
State	:	IN
Zip	:	46038-2637
Country	:	US
Telephone Number	:	317-913-2363
Fax Number	:	317-913-2360

Provider Business Practice Location Address
First Line	:	9670 E WASHINGTON ST
Second Line	:	STE. 235
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3032
Country	:	US
Telephone Number	:	317-899-5000
Fax Number	:	317-899-5723

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/31/2012

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