Provider Demographics
NPI:1649442179
Name:NEWMAN, DUSTIN SCOTT (DDS)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:SCOTT
Last Name:NEWMAN
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 1:25650 DEVANEY RD
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:IN
Mailing Address - Zip Code:46030-9497
Mailing Address - Country:US
Mailing Address - Phone:317-627-1382
Mailing Address - Fax:
Practice Address - Street 1:4758 S SCATTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-2908
Practice Address - Country:US
Practice Address - Phone:765-356-0231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010637A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice