Provider Demographics
NPI:1215977368
Name:KAPP, MICHAEL G (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:KAPP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:10972 ALLISONVILLE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2637
Mailing Address - Country:US
Mailing Address - Phone:317-913-2363
Mailing Address - Fax:317-913-2360
Practice Address - Street 1:9670 E WASHINGTON ST
Practice Address - Street 2:STE. 235
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3032
Practice Address - Country:US
Practice Address - Phone:317-899-5000
Practice Address - Fax:317-899-5723
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN12009299A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200009910Medicaid
IN060320CMedicare ID - Type Unspecified
IN200009910Medicaid