Provider Demographics
NPI:1962561209
Name:OVERMAN, JOHN A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:OVERMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MS
Other - First Name:SHERRIE
Other - Middle Name:L
Other - Last Name:EBERG-FREEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3003 E 98TH ST STE 241
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2907
Mailing Address - Country:US
Mailing Address - Phone:317-846-5894
Mailing Address - Fax:317-846-5986
Practice Address - Street 1:3003 E 98TH ST STE 241
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2907
Practice Address - Country:US
Practice Address - Phone:317-846-5894
Practice Address - Fax:317-846-5986
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN69731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics