KOOL SMILES INI-1, PC (NPI# 1477630556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477630556 |
| Entity Type | Organization |
| Organization Name | KOOL SMILES INI-1, PC |
| Other Organization Name | KOOL SMILES |
| Practice Address |
3658 S East St Indianapolis IN 46227-1239 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 3177815667 |
| Practice Fax Number | 3177815666 |
| Mailing Telephone | 7709165028 |
| Mailing Fax Number | 6782477858 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-12-17 |
| Authorized Official Name | DR. PAUL WALKER (PRESIDENT) |
| Authorized Official Telephone | 7709165028 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Kool Smiles | Doing Business As Name - Organization |
| Street Address |
3658 S EAST ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46227-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457845174 | Ranvita Priya Kolli | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2018-06-16 |
| 1013427095 | Shilpa Agarwal | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2017-10-04 |
| 1265961437 | Marli Leist | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2017-06-09 |
| 1922448521 | Akm Toufiqur Rahman | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2013-06-27 |
| 1265729875 | Dana Mahmoud Awad | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2011-07-03 |
| 1124250659 | Daniel Paul Aldulescu | Dentist | 3658 S East St, Indianapolis, IN 46227-1239 | 2009-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679184477 | Zachry Skinner | Specialist/Technologist | 1683 E Hanna Ave, Indianapolis, IN 46227 | 2020-08-14 |
| 1104481415 | Corinne Mcdonald | Music Therapist | 7502 Madison Avenue, Indianapolis, IN 46227 | 2019-05-02 |
| 1205318649 | Kesha Conner | Counselor | 8320 Madison Ave Indianapolis, In, Indianapolis, IN 46227 | 2018-09-01 |
| 1609369719 | Victoria Lynn West Arnold | Physician Assistant | 1550 E County Line Rd Ste 320, Indianapolis, IN 46227 | 2018-06-13 |
| 1518466960 | Debra Cottongim | Physical Therapy Assistant | 6329 South East St, Ste A, Indianapolis, IN 46227 | 2018-02-12 |
| 1962943019 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 6826 Madison Ave, Indianapolis, IN 46227 | 2017-03-09 |
| 1205386687 | Kylie Rochelle Bontrager | Dentist | 3658 East Street, Indianapolis, IN 46227 | 2016-10-10 |
| 1013371137 | Kayla Ford | Occupational Therapist | 3230 Rue Chanel, Apt 162, Indianapolis, IN 46227 | 2016-04-06 |
| 1639551344 | Sara Allyn Shrivastav | Technician, Other | 3711 E Southport Rd, Indianapolis, IN 46227 | 2015-06-18 |
| 1598146565 | Theodore Christian Seger | Family Medicine | 610 E Southport Rd Ste 205, Indianapolis, IN 46227 | 2015-06-15 |
| Find all providers in zip 46227 | ||||
| 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 | 46227 |
Please comment or provide details below to improve the information on KOOL SMILES INI-1, PC.
| 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.