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Dr. Randolph Ken Shoup, DDS
General Practice Dentistry in Noblesville, Indiana
NPI 1295741577

Randolph Ken Shoup is a General Practice Dentistry based in Noblesville, IN and is specialized in General Practice. Randolph Ken Shoup practices in Noblesville, IN and has the professional credentials of DDS. The NPI Number for Randolph Ken Shoup is 1295741577 and holds a License No. 12008036A (Indiana).

The current practice location address for Randolph Ken Shoup is 14297 Bergen Blvd # 100, Noblesville, IN and can be reached out via phone at 317-776-1100 and via fax at 317-776-1129.

Location: 14297 Bergen Blvd # 100, Noblesville, IN, 46060-3358
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295741577
Provider Name
Randolph Ken Shoup
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
14297 Bergen Blvd # 100, Noblesville, IN, 46060-3358
Phone Number
317-776-1100
Fax Number
317-776-1129
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
14297 Bergen Blvd # 100
City
Noblesville
State
Indiana
Zip
46060-3358
Phone Number
317-776-1100
Fax Number
317-776-1129
person
Provider Business Mailing Address Details
Address
14297 Bergen Blvd # 100
City
Noblesville
State
Indiana
Zip
46060-3358
Phone Number
317-776-1100
Fax Number
317-776-1129
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
12008036A (Indiana)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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