Provider Demographics
NPI:1770078990
Name:PANDYA, BINAL HEMANT (DDS)
Entity type:Individual
Prefix:DR
First Name:BINAL
Middle Name:HEMANT
Last Name:PANDYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4329 THRUSH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-1244
Mailing Address - Country:US
Mailing Address - Phone:317-298-8777
Mailing Address - Fax:
Practice Address - Street 1:5457 W 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2917
Practice Address - Country:US
Practice Address - Phone:317-291-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012969A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice