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NPI Code Detail

MEDICARE: DR. KRISTINE M MOSIER DMD

MEDICARE: DR. KRISTINE M MOSIER DMD
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
1122300000XDentist12010577IN
21223X0008XOral and Maxillofacial Radiology Dentistry12010577IN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00267322OTHERINRAILROAD MEDICARE
3P00816224OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000358075OTHERINANTHEM BCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912946872
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTINE M MOSIER DMD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 N SENATE BLVD
Second Line : ROOM 1204A
City : INDIANAPOLIS
State : IN
Zip : 46202-1239
Country : US
Telephone Number : 317-962-6793
Fax Number : 317-962-8281
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 12/18/2020

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Directions to “ DR. KRISTINE M MOSIER DMD” Practice Location

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