BROAD RIPPLE FAMILY DENTAL, LLC (NPI# 1073840393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073840393 |
| Entity Type | Organization |
| Organization Name | BROAD RIPPLE FAMILY DENTAL, LLC |
| Practice Address |
6117 N College Ave Indianapolis IN 46220-2233 |
| Mailing Address |
6117 N. College Indianapolis IN 46220 |
| Practice Telephone | 3172573368 |
| Mailing Telephone | 3172573368 |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |
| Authorized Official Name | DR. GINA ELROD (DENTIST) |
| Authorized Official Telephone | 3172573368 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
12007547A | IN | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
12010049A | IN | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12010357A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100061910A | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | BROAD RIPPLE FAMILY DENTAL, LLC | 11445 E Via Linda, Suite 2422, Scottsdale, AZ 85259 |
| Street Address |
6117 N COLLEGE AVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46220-2233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366553570 | Gary L Breslauer | Dental Assistant | 6117 N College Ave, Indianapolis, ID 46220 | 2006-08-31 |
| 1144676123 | Indiana Center for Surgical Arts | Dentist | 6117 N College Ave, Suite 4, Indianapolis, IN 46220-2233 | 2016-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255168 | Know The Drill, LLC | Dentist | 6284 Rucker Road, Suite G, Indianapolis, IN 46220 | 2020-01-29 |
| 1902361017 | Stephanie Jean Tellus | Physical Therapist | 5620 Carvel Ave, Indianapolis, IN 46220 | 2019-02-02 |
| 1861972879 | Ashley M Pondexter | Counselor | 820 E 64th St, Indianapolis, IN 46220 | 2018-08-19 |
| 1649766403 | Amy Yonan | Social Worker | 3830 Rue Delacroix, Indianapolis, IN 46220 | 2018-07-05 |
| 1295226066 | Royal Comfort Home Care | In Home Supportive Care | 2804 55th Pl Ste K, Indianapolis, IN 46220 | 2018-05-28 |
| 1104322148 | Jessica Lynn Neidlinger | Counselor | 819 E 64th St Ste 220, Indianapolis, IN 46220 | 2018-03-30 |
| 1497273494 | Squareone Wellness | Nurse Practitioner | 5422 N Keystone Ave, Indianapolis, IN 46220 | 2017-08-30 |
| 1356866834 | Andrea Elaine Tennancour | Nurse Practitioner | My Mobile Md LLC, 7007 Graham Road Suite 215, Indianapolis, IN 46220 | 2017-08-07 |
| 1346762283 | Nicole Shields | Specialist/Technologist | 6020 Carvel Ave, 1234 Unit, Indianapolis, IN 46220 | 2017-07-12 |
| 1972033389 | Laurie Budlong-morse | Marriage & Family Therapist | 815 E 63rd Pl Ste 204, Indianapolis, IN 46220 | 2017-06-18 |
| Find all providers in zip 46220 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770194698 | Dental Professionals of In, P.C. | Dentist | 8570 Northwest Blvd, Indianapolis, IN 46278-1383 | 2020-08-13 |
| 1790322527 | Arlington Westend Dental LLC | Dentist | 5900 E 10th St, Indianapolis, IN 46219 | 2019-11-27 |
| 1932766508 | Brooke Nichole Scott | Dentist | 5501 E 71st St Ste 3, Indianapolis, IN 46220-3900 | 2019-05-20 |
| 1851875546 | Andrew David Power | Dentist | 5869 Lawton Loop East Drive, Indianapolis, IN 46216 | 2018-09-19 |
| 1639652126 | Gh Dental | Dentist | 6925 S Harding St Ste A, Indianapolis, IN 46217-4114 | 2018-09-11 |
| 1326533068 | Bryce Ashton Chambers | Dentist | 6010 W 86th St Ste 118, Indianapolis, IN 46278-1407 | 2018-06-26 |
| 1932694528 | Mfdc of Indiana, Inc | Dentist | 6225 W 56th St Ste 100, Indianapolis, IN 46254-0002 | 2018-06-26 |
| 1306331905 | Mfdc of Indiana, Inc | Dentist | 5935 S Emerson Ave Ste 200, Indianapolis, IN 46237-1975 | 2018-06-26 |
| 1376037853 | Decatur Family Dentistry LLC | Dentist | 5021 Kentucky Ave Ste G, Indianapolis, IN 46221-3650 | 2018-06-19 |
| 1215420252 | Wesley Kenn Burcham | Dentist | 1481 W 10th St # 160, Indianapolis, IN 46202 | 2018-06-13 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46220 |
Please comment or provide details below to improve the information on BROAD RIPPLE FAMILY DENTAL, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.