Provider Demographics
NPI:1851191167
Name:JAIN, SALONI
Entity type:Individual
Prefix:
First Name:SALONI
Middle Name:
Last Name:JAIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 CENTRAL GREENS BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2563
Mailing Address - Country:US
Mailing Address - Phone:248-924-7639
Mailing Address - Fax:
Practice Address - Street 1:68 CENTRAL GREENS BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2563
Practice Address - Country:US
Practice Address - Phone:248-924-7639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD007499133V00000X
OHLD.10742133V00000X
WV1830133V00000X
IN37003527A133V00000X
IA131109133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered