| 86th Street Complete Dental | |
|
3810 W 86th St Indianapolis IN 46268 | |
| (317) 707-6453 | |
| Not Available |
| Full Name | 86th Street Complete Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 3810 W 86th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Mona P Singh (OWNER) |
| Authorized Official Contact | 3177484603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 86th Street Complete Dental 3810 W 86th St Indianapolis IN 46268-1905 Ph: (317) 707-6453 | 86th Street Complete Dental 3810 W 86th St Indianapolis IN 46268 Ph: (317) 707-6453 |
| NPI Number | 1194247940 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 02/26/2024 |
| Medicare PECOS PAC ID | 0749536811 |
|---|---|
| Medicare Enrollment ID | O20180702003560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194247940 | NPI | - | NPPES |
| 300015766 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Mona P Singh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1629427828 PECOS PAC ID: 8022301852 Enrollment ID: I20180711002547 |
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