Provider Demographics
NPI:1730144510
Name:HIPLE, EVAN R (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:R
Last Name:HIPLE
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 1:318 W TANSEY XING
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-9743
Mailing Address - Country:US
Mailing Address - Phone:317-566-1610
Mailing Address - Fax:
Practice Address - Street 1:630 3RD AVE SW
Practice Address - Street 2:SUITE 150
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2086
Practice Address - Country:US
Practice Address - Phone:317-843-9760
Practice Address - Fax:317-843-9761
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010447A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice