# REGION DENTAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Region Dental Group, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881311736
- **Authorized official:** AJMAL S. WARDAK DDS (DENTIST/OWNER)
- **Authorized official phone:** (317) 225-6666

## Contact information

- **Practice address:** 713 US HIGHWAY 41 STE A, SCHERERVILLE, IN 46375-1798
- **Practice address phone:** (219) 227-8694
- **Practice address fax:** (219) 266-5894
- **Mailing address:** 713 US HIGHWAY 41 STE A, SCHERERVILLE, IN 46375-1798
- **Mailing address phone:** (219) 227-8694
- **Mailing address fax:** (219) 266-5894

## Taxonomy

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

## Other

- **Enumeration date:** 10/21/2022
- **Last updated:** 10/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1588793913 | DENTAL | IN |