Amazing Dental
Dentist in Evansville, IN. Organization (NPI-2).
NPI number1174841126
StatusActive
Last updated in NPPESMay 13, 2010
Details
- NPI
- 1174841126
- Entity type
- Organization (NPI-2)
- Legal business name
- Amazing Dental
- Organization subpart
- No
- Enumeration date
- May 13, 2010
- Last updated
- May 13, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 12011105A | IN | Yes |
Practice location
5200 Washington AveSuite E
Evansville, IN 47715-4863
Phone 812-488-2008 · Fax 812-475-9831
Mailing address
5200 Washington AveSuite E
Evansville, IN 47715-4863
Phone 812-488-2008 · Fax 812-475-9831
Authorized official
Ruthie M Jimerson
President
8124882008
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