MEDICARE: HIPLE FAMILY DENTISTRY, P.C.

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	12010447A	IN

General Provider Information

NPI Number	:	1801983812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIPLE FAMILY DENTISTRY, P.C.

Provider Business Mailing Address
First Line	:	630 3RD AVE SW
Second Line	:	SUITE 150
City	:	CARMEL
State	:	IN
Zip	:	46032-2086
Country	:	US
Telephone Number	:	317-843-9760
Fax Number	:	317-843-9761

Provider Business Practice Location Address
First Line	:	630 3RD AVE SW
Second Line	:	SUITE 150
City	:	CARMEL
State	:	IN
Zip	:	46032-2086
Country	:	US
Telephone Number	:	317-843-9760
Fax Number	:	317-843-9761

Authorized Official
Title or Position	:	DENTIST / OWNER
Name	:	DR. EVAN R HIPLE
Credential	:	D.D.S.
Telephone Number	:	317-843-9760

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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