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Organization
INDIANA UNIVERSITY
Active
Organization
INDIANA UNIVERSITY
Active
Other names
Indiana University School of Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
TINA D FOSTER (ASSISTANT DIRECTOR OF REVENUE CYCLE)
(317) 278-3632
Entity
Organization
Contact information
Practice address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(317) 274-7433
Mailing address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(317) 278-3632
(317) 274-2603
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100277260
—
IN
Enumeration date
03/22/2007
Last updated
02/24/2023
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