# MITRA NIKPOUR; D.D.S. LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INDIANA DENTAL CENTER ON SHERMAN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235574724
- **Authorized official:** MITRA NIKPOUR D.D.S. (OWNER)
- **Authorized official phone:** (317) 545-6011

## Contact information

- **Practice address:** 3628 N SHERMAN DR, INDIANAPOLIS, IN 46218-1436
- **Practice address phone:** (317) 545-6011
- **Mailing address:** PO BOX 301014, INDIANAPOLIS, IN 46230-1014
- **Mailing address phone:** (832) 618-6647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12011731A | IN | Yes |

## Other

- **Enumeration date:** 05/09/2013
- **Last updated:** 05/09/2013