Broad Ripple Family Dental, Llc

LBN: Broad Ripple Family Dental, Llc
Broad Ripple Family Dental, Llc is an health care organization with primary practice located at 6117 N College Ave , Indianapolis IN 46220-2233. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Broad Ripple Family Dental, Llc can be contacted via phone (317) 257-3368, or through Elrod, Gina via phone (317) 257-3368.

Contact Information

Primary practice address
6117 N College Ave Indianapolis IN 46220-2233
Phone: (317) 257-3368
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Elrod, Gina
Phone: (317) 257-3368

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12007547A Indiana
Dental Providers / General Practice 1223G0001X 12010049A Indiana
Dental Providers / General Practice 1223G0001X 12010357A Indiana

Profile Details

NPI number 1073840393
LBN Legal business name Broad Ripple Family Dental, Llc
DBA Doing business as
Authorized official Elrod, Gina
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2009
Last updated Nov 6th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073840393 NPPES
Indiana MEDICAID 100061910A

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