# WEST INDY PIPPIN DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pippin Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356816037
- **Authorized official:** DR. DALE MAYFIELD DMD (PRESIDENT)
- **Authorized official phone:** (770) 916-5036

## Contact information

- **Practice address:** 8252 ROCKVILLE RD, INDIANAPOLIS, IN 46214-3113
- **Practice address phone:** (317) 352-2922
- **Mailing address:** 1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
- **Mailing address phone:** (770) 916-5036
- **Mailing address fax:** (678) 285-4760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |

## Other

- **Enumeration date:** 10/09/2018
- **Last updated:** 10/09/2018