Provider Demographics
NPI:1447770904
Name:STUDEBAKER, NEELAM VACHHANI
Entity Type:Individual
Prefix:DR
First Name:NEELAM
Middle Name:VACHHANI
Last Name:STUDEBAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11135 PENDLETON PIKE STE 900
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-2872
Mailing Address - Country:US
Mailing Address - Phone:317-826-3441
Mailing Address - Fax:
Practice Address - Street 1:11135 PENDLETON PIKE STE 900
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2872
Practice Address - Country:US
Practice Address - Phone:317-826-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012711A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist