Neeraj Trehan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12014317A Issued in IN

Practice address

206 W Ireland Rd
South Bend, IN 46614-2506

Phone

(913) 905-2711

NPI assigned

Nov 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1104460260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142506",
            "telephone_number": "913-905-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142506",
            "telephone_number": "913-905-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Avenue D Ste 100",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982902018",
            "country_code": "US",
            "telephone_number": "360-568-9694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 Albany Street",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-358-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 E Markey Pkwy",
            "address_purpose": "LOCATION",
            "city": "Belton",
            "state": "MO",
            "postal_code": "640122162",
            "country_code": "US",
            "telephone_number": "816-535-3443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7524 State Ave",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661122816",
            "country_code": "US",
            "telephone_number": "913-905-2711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREHAN",
        "first_name": "NEERAJ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-01",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021021829",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62031",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014317A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in South Bend, IN
• Providers in South Bend, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.