Provider Demographics
NPI:1235410770
Name:NANCY Z. HALSEMA, D.D.S., P.C.
Entity Type:Organization
Organization Name:NANCY Z. HALSEMA, D.D.S., P.C.
Other - Org Name:CARMEL WEST DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HALSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-253-8631
Mailing Address - Street 1:3965 W 106TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7750
Mailing Address - Country:US
Mailing Address - Phone:317-253-8631
Mailing Address - Fax:317-876-9715
Practice Address - Street 1:3965 W 106TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7750
Practice Address - Country:US
Practice Address - Phone:317-253-8631
Practice Address - Fax:317-876-9715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1043363971OtherNPI TYPE 1