Louly Dentistry, Inc - Medicare Dental Clinic in Indianapolis, IN

Louly Dentistry, Inc is a medicare enrolled dental clinic (Dentist) in Indianapolis, Indiana. The current practice location for Louly Dentistry, Inc is 11530 E Washington Street, Indianapolis, Indiana. For appointments, you can reach them via phone at (317) 869-0000. The mailing address for Louly Dentistry, Inc is 11530 E Washington Street, Indianapolis, Indiana and phone number is (317) 869-0000.

Louly Dentistry, Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1003104043. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (317) 869-0000.

Contact Information

Louly Dentistry, Inc
11530 E Washington Street
Indianapolis
IN 46229-2828
(317) 869-0000
(317) 869-0233

Dental Care Clinic Profile

Full NameLouly Dentistry, Inc
SpecialityDentist
Location11530 E Washington Street, Indianapolis, Indiana
Authorized Official Name and PositionAmmar C. Louly (PRESIDENT)
Authorized Official Contact3178690000
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Louly Dentistry, Inc
11530 E Washington Street
Indianapolis
IN 46229-2828

Ph: (317) 869-0000
Louly Dentistry, Inc
11530 E Washington Street
Indianapolis
IN 46229-2828

Ph: (317) 869-0000

NPI Details:

NPI Number1003104043
Provider Enumeration Date07/12/2011
Last Update Date05/25/2023

Medicare PECOS Information:

Medicare PECOS PAC ID4082882360
Medicare Enrollment IDO20110713000443

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Medical Identifiers

Medical identifiers for Louly Dentistry, Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003104043NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist (* (Not Available))Primary
1223P0700XDentist - Prosthodontics 12009247A (Indiana)Secondary
1223P0700XDentist - Prosthodontics (* (Not Available))Secondary
332B00000XDurable Medical Equipment & Medical Supplies (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Louly Dentistry, Inc acts as a billing entity for following providers:
Provider NameAmmar C Louly
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1699808899
PECOS PAC ID: 1355519539
Enrollment ID: I20110713000464

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