Provider Demographics
NPI:1710092044
Name:SCHINBECKLER, GARY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:SCHINBECKLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 S SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-6278
Mailing Address - Country:US
Mailing Address - Phone:317-882-2595
Mailing Address - Fax:317-882-5745
Practice Address - Street 1:8101 S SHELBY ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6278
Practice Address - Country:US
Practice Address - Phone:317-882-2595
Practice Address - Fax:317-882-5745
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U60183Medicare UPIN
076950Medicare ID - Type Unspecified