Provider Demographics
NPI:1376837070
Name:STEELE PEDIATRIC DENTISTRY LLC
Entity Type:Organization
Organization Name:STEELE PEDIATRIC DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-517-7620
Mailing Address - Street 1:9602 E WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3060
Mailing Address - Country:US
Mailing Address - Phone:317-899-5437
Mailing Address - Fax:317-897-0771
Practice Address - Street 1:9602 E WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3060
Practice Address - Country:US
Practice Address - Phone:317-899-5437
Practice Address - Fax:317-897-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010792A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty