# SERENITY CREEK DENTAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326781212
- **Authorized official:** KELLY ELIKOFER DDS (OWNER / DENTIST)
- **Authorized official phone:** (317) 417-1221

## Contact information

- **Practice address:** 298 S 10TH ST STE 100, NOBLESVILLE, IN 46060-2741
- **Practice address phone:** (317) 417-1221
- **Mailing address:** 298 S 10TH ST STE 100, NOBLESVILLE, IN 46060-2741
- **Mailing address phone:** (317) 417-1221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2022
- **Last updated:** 04/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12012146A | IN DENTAL LICENSE | IN |
| 01 | — | 1881008399 | NPI TYPE 1 | IN |