Provider Demographics
NPI:1528199510
Name:FORGEY, JOE EDWARD (DDS, FACD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:EDWARD
Last Name:FORGEY
Suffix:
Gender:M
Credentials:DDS, FACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LAKEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1307
Mailing Address - Country:US
Mailing Address - Phone:317-773-3617
Mailing Address - Fax:317-773-2360
Practice Address - Street 1:106 LAKEVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1307
Practice Address - Country:US
Practice Address - Phone:317-773-3617
Practice Address - Fax:317-773-2360
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120072331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN107318OtherCSHCS