Provider Demographics
NPI:1154548154
Name:ISIKBAY, SERKIS CENGIZ (DDS)
Entity type:Individual
Prefix:DR
First Name:SERKIS
Middle Name:CENGIZ
Last Name:ISIKBAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 CUNNINGHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:SPEEDWAY
Mailing Address - State:IN
Mailing Address - Zip Code:46224-5341
Mailing Address - Country:US
Mailing Address - Phone:317-248-8370
Mailing Address - Fax:
Practice Address - Street 1:1121 WEST MICHIGAN STREET
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-274-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009720A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist