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In Oral and Facial Surgery — NPI 1265222103, Indianapolis, IN | NPI Central

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NPI 1265222103

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In Oral and Facial Surgery

NPI 1265222103 · Oral and Maxillofacial Surgery (Dentist) · Indianapolis, IN

Provider details

NPI number: 1265222103
Entity type: Organization
Primary specialty: Oral and Maxillofacial Surgery (Dentist)Dental Providers
Organization subpart: No
Authorized official: Jackie Holloway, Director of Rcm(854) 200-7970

Specialties & taxonomies

Oral and Maxillofacial Surgery (Dentist)Primary1223S0112X
Dental Providers

Practice location

1320 N Post Rd

Indianapolis, IN 46219-4210

Phone: (317) 898-2555

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

3700 Ingleside Blvd

Ladson, SC 29456-4141

Other names (DBA / former)

Former legal business name: Indianapolis Oral Surgery and Dental Implant Center

Registry dates

Enumerated: 2025-05-12
Last updated: 2025-05-12
Certified: 2025-05-12

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.