Provider Demographics
NPI:1316430689
Name:ALBEE, JILLIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:ALBEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 KESSLER BOULEVARD NORTH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-2814
Mailing Address - Country:US
Mailing Address - Phone:858-922-9955
Mailing Address - Fax:
Practice Address - Street 1:1522 W MORRIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46221-1629
Practice Address - Country:US
Practice Address - Phone:317-957-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012925A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist