MEDICARE: SITARAM INVESTMENTS, LLC

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	1223G0001X	General Practice Dentistry	12010835A	IN

General Provider Information

NPI Number	:	1528197076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SITARAM INVESTMENTS, LLC

Provider Business Mailing Address
First Line	:	105 SOUTH RACEWAY ROAD
Second Line	:	SUITE 140
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231
Country	:	US
Telephone Number	:	317-273-9666
Fax Number	:	317-273-9666

Provider Business Practice Location Address
First Line	:	105 SOUTH RACEWAY ROAD
Second Line	:	SUITE 140
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231
Country	:	US
Telephone Number	:	317-273-9666
Fax Number	:	317-273-9666

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DIPESH SITARAM
Credential	:	DDS
Telephone Number	:	317-506-8350

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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