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Dr. David Kruse Tabereaux, DDS

Dentist in Bloomington, IN. Individual provider (NPI-1).

NPI number1255468567
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1255468567
Entity type
Individual (NPI-1)
Name
Dr. David Kruse Tabereaux
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Feb 27, 2007
Last updated
Jul 8, 2007

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 codeDescriptionLicenseStatePrimary
122300000X Dentist7527INYes

Practice location

857 Auto Mall Rd
Bloomington, IN 47401

Phone 812-332-2858 · Fax 812-333-0242

Mailing address

857 Auto Mall Rd
Bloomington, IN 47401

Phone 812-332-2858

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist providers in Bloomington, IN

All 40 Dentist providers in Bloomington · All 4,023 providers in Bloomington

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