Provider Demographics
NPI:1407384290
Name:HIPPENMEYER, LAUREN ELAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELAINE
Last Name:HIPPENMEYER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3265 STREAMSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7810
Mailing Address - Country:US
Mailing Address - Phone:317-345-1620
Mailing Address - Fax:
Practice Address - Street 1:6919 E 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4893
Practice Address - Country:US
Practice Address - Phone:317-358-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012709A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice