Provider Demographics
NPI:1902963507
Name:LERNER, CARL (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8937 SOUTHPOINTE DR
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-1086
Mailing Address - Country:US
Mailing Address - Phone:317-300-0535
Mailing Address - Fax:317-300-0691
Practice Address - Street 1:8937 SOUTHPOINTE DR
Practice Address - Street 2:SUITE A-2
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1086
Practice Address - Country:US
Practice Address - Phone:317-300-0535
Practice Address - Fax:317-300-0691
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009129A1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics