MERIDIAN STREET PERIODONTICS, LLC (NPI# 1518470897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518470897 |
| Entity Type | Organization |
| Organization Name | MERIDIAN STREET PERIODONTICS, LLC |
| Other Organization Name | IMPLANT DENTISTRY AND PERIODONTICS |
| Practice Address |
8801 N Meridian St Ste 103 Indianapolis IN 46260-2353 |
| Mailing Address |
8037 Sargent Rdg Indianapolis IN 46256-1848 |
| Practice Telephone | 3175740600 |
| Practice Fax Number | 3175740606 |
| Mailing Telephone | 3175740600 |
| Mailing Fax Number | 3175740606 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |
| Authorized Official Name | ASHLEY THURMAN (OFFICE MANAGER) |
| Authorized Official Telephone | 3178428453 |
| Authorized Official Credential | EFDA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
12010349A | IN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Implant Dentistry and Periodontics | Doing Business As Name - Organization |
| Street Address |
8801 N MERIDIAN ST STE 103 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46260-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
| 1225666589 | Alexander Michael Kiel | Student in an Organized Health Care Education/Training Program | Internal Medicine 3 North, 2001 W. 86th Street, Indianapolis, IN 46260 | 2020-03-31 |
| 1043793151 | Lisa R Foreman | Registered Nurse | 1389 W. 86th Street Unit # 238, Indianapolis, IN 46260 | 2018-09-13 |
| 1790268399 | Esther Muturi | Chore Provider | 1214 Racquetclub South Drive Apt C, Indianapolis, IN 46260 | 2018-09-10 |
| 1912483215 | Katherine Donnelly | Community Health Worker | 1612 Lancashire Ct, Indianapolis, IN 46260 | 2018-07-19 |
| 1326539628 | Peaceful Source Midwifery LLC | Advanced Practice Midwife | 1139 Canterbury Ct., Unit B, Indianapolis, IN 46260 | 2018-05-22 |
| 1144722695 | Mindful Services Center LLC | Clinic/Center | 9002 N Meridian St, Ste 200, Indianapolis, IN 46260 | 2018-03-01 |
| 1144731910 | Meenu Jain | Student in an Organized Health Care Education/Training Program | Internal Medicine, 8414 Naab Road, Suite 100, Indianapolis, IN 46260 | 2017-10-19 |
| 1609392422 | 1717 Senior Living, LLC | Assisted Living Facility | 1703 West 86th Street, Indianapolis, IN 46260 | 2017-08-15 |
| 1093246985 | Royalty Transports LLC | Bus | 2255 W. 67th St., Indianapolis, IN 46260 | 2017-03-23 |
| Find all providers in zip 46260 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421965 | Hawra Alqallaf | Dentist | 1121 W Michigan St # Ds422, Indianapolis, IN 46202-5211 | 2019-08-05 |
| 1164726832 | Indy East Periodontics PC | Dentist | 115 N Shortridge Rd Ste 100, Indianapolis, IN 46219-4917 | 2011-01-10 |
| 1831316769 | Michael Kevin Gossweiler | Dentist | 7537 W 38th St, Indianapolis, IN 46254-2937 | 2007-04-20 |
| 1942358007 | Daniel Gomes | Dentist | 8235 Country Village Dr, Indianapolis, IN 46214 | 2007-01-08 |
| 1902963507 | Carl Lerner | Dentist | 8937 Southpointe Dr, Suite A-2, Indianapolis, IN 46227-1086 | 2007-01-02 |
| 1962561209 | John A Overman | Dentist | 3003 E 98th St Ste 241, Indianapolis, IN 46280-2907 | 2006-12-06 |
| 1790864445 | Stephen B Towns | Dentist | 508 Indiana Ave, Indianapolis, IN 46202-3106 | 2006-11-03 |
| 1295816007 | Kurt David Vanwinkle | Dentist | 8902 N Meridian St Ste 138, Indianapolis, IN 46260-5306 | 2006-10-18 |
| 1427067289 | Jay R Beagle | Dentist | 3003 E 98th St Ste 200, Indianapolis, IN 46280-1973 | 2006-08-07 |
| 1740225556 | Bruce B Wiland | Dentist | 5162 E Stop 11 Rd, Suite 2, Indianapolis, IN 46237-8617 | 2006-06-17 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46260 |
Please comment or provide details below to improve the information on MERIDIAN STREET PERIODONTICS, 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.