IndividualActive
Jeffrey Bennett, DMD
NPI 1053416602 · Oral and Maxillofacial Surgery (Dentist) · Indianapolis, IN
Provider details
- NPI number
- 1053416602
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- 12010608A (IN)
Specialties & taxonomies
Dental Providers
Practice location
1050 Wishard Blvd
Room 4201
Indianapolis, IN 46202-2872
Phone: (317) 278-3699
Fax: (317) 278-2243
Approximate (ZIP-level) locationGet directions
Mailing address
1050 Wishard Blvd
Indianapolis, IN 46202-2872
Registry dates
- Enumerated
- 2006-09-14
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.