EAST CENTRAL INDIANA ORAL AND MAXILLOFACIAL SURGERY, LLC (NPI# 1720330004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720330004 |
Entity Type | Organization |
Organization Name | EAST CENTRAL INDIANA ORAL AND MAXILLOFACIAL SURGERY, LLC |
Practice Address |
3895 N Wheeling Ave Muncie IN 47304-1776 |
Practice Telephone | 7652811131 |
Mailing Telephone | 7652811131 |
Enumeration Date | 2012-10-10 |
Last Update Date | 2012-10-10 |
Authorized Official Name | DR. HARRY PAPADOPOULOS (PRACTICE CO-OWNER) |
Authorized Official Telephone | 7652811131 |
Authorized Official Credential | DDS, MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
12010966A | IN | Ambulatory Health Care Facilities |
Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
12008702A | IN | Ambulatory Health Care Facilities |
Street Address |
3895 N WHEELING AVE |
City | MUNCIE |
State | IN |
Zip Code | 47304-1776 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790337020 | Clear Chiropractic Muncie, LLC | Chiropractor | 3895 N Wheeling Ave, Muncie, IN 47304-1776 | 2019-07-16 |
1336538560 | Michael Joseph Jobe | Chiropractor | 3895 N Wheeling Ave, Muncie, IN 47304-1776 | 2015-01-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821627191 | Free To Flourish Counseling and Consulting | Marriage & Family Therapist | 4304 W Coyote Run Court, Muncie, IN 47304 | 2020-04-07 |
1205477957 | Muncie Treatment Center, LLC | Clinic/Center | 3640 Briarwood Lane, Muncie, IN 47304 | 2019-10-03 |
1508415225 | Susanna Florence Nalliah I | Pharmacist | Iu Health Ball Memorial Hospital Inpatient Pharmacy, 2401 W. University Ave, Muncie, IN 47304 | 2019-09-05 |
1235624289 | Kregg Koons O.d., Inc. | Optometrist | 3300 Purdue Ave., Muncie, IN 47304 | 2018-06-22 |
1013409242 | Julia Powers | Social Worker | 8425 W Ashford Ln, Muncie, IN 47304 | 2018-06-04 |
1851803456 | Dianna Marie Johnson | Nurse Practitioner | 3411 N Briarwood Ln, Muncie, IN 47304 | 2017-11-04 |
1780082917 | Quad Med LLC | Clinic/Center | 3800 West Kilgore Ave, Muncie, IN 47304 | 2014-12-22 |
1629418173 | Mark Allen Wise | Physical Therapist | 3607 N Everbrook Lane, Muncie, IN 47304 | 2013-06-28 |
1396094280 | Planned Parenthood of Indiana Muncie | Clinic/Center | 3550 W. Fox Ridge Lane, Muncie, IN 47304 | 2012-09-06 |
1043595655 | Olukayode Bamidele | Physical Therapist | 3601 W. Moore Road, Muncie, IN 47304 | 2011-10-14 |
Find all providers in zip 47304 |
Taxonomy Code | 261QS0112X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740548015 | Benson Oral Surgery and Dental Implants, LLC | Clinic/Center | 8809 W 400 N, Suite 2, Michigan City, IN 46360-9330 | 2012-04-24 |
1891063368 | Cameron Conkin Dds, Oral and Maxillofacial Surgeon, LLC | Clinic/Center | 8101 Shelby St, Ste A, Indianapolis, IN 46227-6224 | 2011-12-12 |
1073819041 | Allan L. Reid Psc | Clinic/Center | 4828 Lincoln Ave, Evansville, IN 47715-4110 | 2011-02-08 |
1881887065 | Edison Lakes Oral Surgery, P.C. | Clinic/Center | 270 E Day Rd, Suite 260, Mishawaka, IN 46545-3444 | 2007-08-22 |
1346309374 | Kokomo Oral and Maxillofacial Surgery P.C. | Clinic/Center | 2705 S Berkley Rd, Suite 4d, Kokomo, IN 46902-8025 | 2006-12-06 |
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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.