Ryan Campbell Jay, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010606A Issued in IN

Practice address

12110 Pendleton Pike
Indianapolis, IN 46236

Phone

(317) 826-1050

Fax

(317) 826-1065

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• IL HMO C-SNP
• KY PPO C-SNP
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1003861287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 PENDLETON PIKE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46236",
            "telephone_number": "317-826-1050",
            "fax_number": "317-826-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 PENDLETON PIKE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46236",
            "telephone_number": "317-826-1050",
            "fax_number": "317-826-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAY",
        "first_name": "RYAN",
        "middle_name": "CAMPBELL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010606A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200460270A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071480A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Javit, PHARMD
• Samreen Jawaid, MD
• Jay a. Hollander, D.D.S., P.C.
• Jay E. Cowan, D.D.S. Professional Services Corporation
• James Landon Jay
• Stephen Jordan Jay, M.D.
• Mercy Jayakumar
• Thilaka Jayaprakash
• Shantha Ni Jayaram, BPHARM
• Keshav Kishore Jayaraman

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.