Provider Demographics
NPI:1366519746
Name:CABBELL, SHAWN (DDS)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:CABBELL
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 1:3640 REFLECTIONS LN
Mailing Address - Street 2:#2
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-4083
Mailing Address - Country:US
Mailing Address - Phone:317-361-2745
Mailing Address - Fax:317-245-2134
Practice Address - Street 1:622 N MADISON AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-4052
Practice Address - Country:US
Practice Address - Phone:317-888-9240
Practice Address - Fax:317-245-2134
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010607A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice