NPIMap

Individual provider Active NPI

Jeffrey A Taylor, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1083027353
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12012151A Issued in IN
Practice address
6333 W Thompson Rd
Indianapolis, IN 46221-3619
Phone
(317) 856-5050
Fax
(317) 856-5091
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12012151A IN Primary

Addresses

Primary practice location

6333 W Thompson Rd
Indianapolis, IN 46221-3619

Mailing address

6333 W Thompson Rd
Indianapolis, IN 46221-3619
Phone (317) 856-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12012151AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fields Family Dentistry, LLC General Practice Past Accepting new patients
Decatur Family Dentistry LLC General Practice Past Accepting new patients
Decatur Family Dentistry LLC General Practice Past Accepting new patients
Fields 20/20 Dental, LLC General Practice Past Accepting new patients

Organizations & group practices 4

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1083027353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 W THOMPSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462213619",
            "telephone_number": "317-856-5050",
            "fax_number": "317-856-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 W THOMPSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462213619",
            "telephone_number": "317-856-5050",
            "fax_number": "317-856-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012151A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.