Provider Demographics
NPI:1275562530
Name:STERLEY, DIRK ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIRK
Middle Name:ALAN
Last Name:STERLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 WINTERSTILL RD
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-8006
Mailing Address - Country:US
Mailing Address - Phone:317-873-0999
Mailing Address - Fax:
Practice Address - Street 1:6545 CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1787
Practice Address - Country:US
Practice Address - Phone:317-251-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN73851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice