Individual provider Active NPI

Alison Landgraf, DMD

  • Dentist
  • Terre Haute, IN
National Provider Identifier
1013534486
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
121014619A Issued in IN
Practice address
1128 Wabash Ave
Terre Haute, IN 47807-3212
Phone
(812) 234-2488
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 016.0133961 VT
Dentist 122300000X 121014619A IN Primary

Addresses

Primary practice location

1128 Wabash Ave
Terre Haute, IN 47807-3212

Mailing address

1242 Otis Dr
Niles, MI 49120-8928
Phone (574) 807-1526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20200929003206 VT Practitioner - Dentist 9931528601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121014619AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region Inc CurrentSince Sep 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Dentist CurrentSince Sep 1, 2020 Accepting new patients

Locations

69 Allen St
Ste 10
Rutland, VT 05701
Phone (802) 774-5050

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1013534486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1242 OTIS DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491208928",
            "telephone_number": "574-807-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 WABASH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478073212",
            "telephone_number": "812-234-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGRAF",
        "first_name": "ALISON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0133961",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "121014619A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.