Provider Demographics
NPI:1477036788
Name:URGENT DENTAL CENTER NORTH LLC
Entity Type:Organization
Organization Name:URGENT DENTAL CENTER NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-894-0631
Mailing Address - Street 1:4930 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-1959
Mailing Address - Country:US
Mailing Address - Phone:317-559-5799
Mailing Address - Fax:317-389-5496
Practice Address - Street 1:7911 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1915
Practice Address - Country:US
Practice Address - Phone:317-559-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty