1972605111 NPI number — MR. YUVAL ARAZI DDS

Table of content: MR. YUVAL ARAZI DDS (NPI 1972605111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972605111 NPI number — MR. YUVAL ARAZI DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARAZI
Provider First Name:
YUVAL
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972605111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2169 GLEBE ST
Provider Second Line Business Mailing Address:
SUITE NUMBER 200
Provider Business Mailing Address City Name:
CARMEL
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46032-7294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-575-6101
Provider Business Mailing Address Fax Number:
317-575-6155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2169 GLEBE ST
Provider Second Line Business Practice Location Address:
SUITE NUMBER 200
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032-7294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-575-6101
Provider Business Practice Location Address Fax Number:
317-575-6155
Provider Enumeration Date:
09/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  12009945 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200304870 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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