Provider Demographics
NPI:1871085167
Name:BRACES FOR U
Entity type:Organization
Organization Name:BRACES FOR U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:RANA
Authorized Official - Last Name:MAHAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-797-6688
Mailing Address - Street 1:4222 KATTMAN CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-1108
Mailing Address - Country:US
Mailing Address - Phone:317-797-6688
Mailing Address - Fax:
Practice Address - Street 1:9126 TECHNOLOGY LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3064
Practice Address - Country:US
Practice Address - Phone:317-797-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011584A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty