Individual provider Active NPI

Ajaydeep Singh

  • Dentist
  • Merrillville, IN
National Provider Identifier
1063919140
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012974A Issued in IN
Practice address
532 E 81St Ave
Merrillville, IN 46410
Phone
(219) 525-0502
NPI assigned
Apr 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 12012974A IN Primary

Addresses

Primary practice location

532 E 81St Ave
Merrillville, IN 46410

Mailing address

532 E 81St Ave
Merrillville, IN 46410-5599
Phone (219) 525-0502

Other practice location 1

8060 N Shadeland Ave Ste B
Indianapolis, IN 46250-2690
Phone (317) 288-5023

Other practice location 2

Family Health of Darke County- Greenvi
5735 Meeker Road
Greenville, OH 45331
Phone (937) 548-9680

Other practice location 3

Family Health of Darke County- Greenvi
5735 Meeker Road
Greenville, OH 45331
Phone (937) 548-9680

Other identifiers 1

IdentifierTypeStateIssuer
00OtherSTUDENT IN AN ORGANIZED HEALTHCARE EDUCATION/TRAINING PROGRAM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200106002883 IN Order and Referring Only - DentistPractitioner - Dentist 7113351818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012974AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Payless Dental & Implants Dentist Current Accepting new patients
Emergency Dentist,LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ajaydeep.singh.p1@direct.northshorehealth.nextgenshare.com

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1063919140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105599",
            "telephone_number": "219-525-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 E 81ST AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-525-0502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8060 N Shadeland Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462502690",
            "country_code": "US",
            "telephone_number": "317-288-5023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Family Health of Darke County- Greenvi",
            "address_2": "5735 Meeker Road",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "45331",
            "country_code": "US",
            "telephone_number": "937-548-9680",
            "fax_number": "937-548-2087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Family Health of Darke County- Greenvi",
            "address_2": "5735 Meeker Road",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "45331",
            "country_code": "US",
            "telephone_number": "937-548-9680",
            "fax_number": "937-548-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINGH",
        "first_name": "AJAYDEEP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012974A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT IN AN ORGANIZED HEALTHCARE EDUCATION/TRAINING PROGRAM",
            "identifier": "00",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.