Vickery, Jeannie M
Vickery, Jeannie M is an sole proprietor health care provider with primary practice located at 1121 W Michigan Street Ds307B, Indianapolis IN 46202-5186. She recently has only one registered license in Dental Providers / Prosthodontics, which is considered as her primary health care specialty. Vickery, Jeannie M can be contacted via phone (317) 278-3632.Contact Information
Primary practice address
1121 W Michigan Street Ds307B
Indianapolis IN 46202-5186
Phone: (317) 278-3632
Fax: (317) 274-2603
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Prosthodontics | 1223P0700X | 12007392A | Indiana |
Profile Details
| NPI number | 1265769780 |
|---|---|
| LBN Legal business name | Vickery, Jeannie M |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 4th, 2009 |
| Last updated | Nov 3rd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265769780 | NPPES |
| Other | 12007392A | INDIANA DENTAL LICENSE |
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