Provider Demographics
NPI:1508978198
Name:DANIEL R. ZIMNY DDS PC
Entity Type:Organization
Organization Name:DANIEL R. ZIMNY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZIMNY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-398-4650
Mailing Address - Street 1:301 WELLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-2229
Mailing Address - Country:US
Mailing Address - Phone:317-398-4650
Mailing Address - Fax:317-398-4775
Practice Address - Street 1:301 WELLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-2229
Practice Address - Country:US
Practice Address - Phone:317-398-4650
Practice Address - Fax:317-398-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120071091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty