Individual provider Active NPI

Jinhai Zhang, DDS

  • General Practice Dentistry
  • Lafayette, IN
National Provider Identifier
1083368708
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014002A Issued in IN
Practice address
1324 Tippecanoe St
Lafayette, IN 47904-2051
Phone
(765) 742-1567
Fax
(765) 429-2794
NPI assigned
Feb 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 12014002A IN Primary

Addresses

Primary practice location

1324 Tippecanoe St
Lafayette, IN 47904-2051

Mailing address

1716 Hartford St
Lafayette, IN 47904-2138
Phone (765) 742-1567

Other practice location 1

416 W Camp St
Lebanon, IN 46052-1799
Phone (765) 483-4469

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
I20230721001876 IN Practitioner - Dentist 7113387168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12014002AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Community Health Clinic, Inc CurrentSince Jul 20, 2023 Accepting new patients
Riggs Community Health Center Inc PastSince Jul 20, 2023 Accepting new patients

Locations

416 W Camp St
Lebanon, IN 46052
Phone (765) 483-4469

Organizations & group practices 3

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1083368708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 TIPPECANOE ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042051",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 W Camp St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "IN",
            "postal_code": "460521799",
            "country_code": "US",
            "telephone_number": "765-483-4469",
            "fax_number": "765-483-4495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "JINHAI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014002A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.