Provider Demographics
NPI:1154448868
Name:SCOTT T. ROSENFELD, D.D.S., P.C.
Entity Type:Organization
Organization Name:SCOTT T. ROSENFELD, D.D.S., P.C.
Other - Org Name:SCOTT T. ROSENFELD, D.D.S.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-846-6653
Mailing Address - Street 1:8902 N MERIDIAN ST
Mailing Address - Street 2:SUITE 237
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5382
Mailing Address - Country:US
Mailing Address - Phone:317-846-6653
Mailing Address - Fax:317-846-6675
Practice Address - Street 1:8902 N MERIDIAN ST
Practice Address - Street 2:SUITE 237
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5382
Practice Address - Country:US
Practice Address - Phone:317-846-6653
Practice Address - Fax:317-846-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120095251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty