NPIMap

Individual provider Active NPI

Jason Renz, D.D.S.

  • Dentist
  • Fishers, IN
National Provider Identifier
1144603242
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012356A Issued in IN
Practice address
11559 Cumberland Rd
Suite 100
Fishers, IN 46037-9784
Phone
(317) 579-5400
Fax
(317) 579-5410
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012356A IN Primary

Addresses

Primary practice location

11559 Cumberland Rd
Suite 100
Fishers, IN 46037-9784

Mailing address

14958 Bonner Cir
Fishers, IN 46037-5512
Phone (574) 952-7324

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
12012356AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven M Green D D S P C Past Accepting new patients
Hoosier Sleep Solutions LLC Past Accepting new patients

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1144603242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14958 BONNER CIR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460375512",
            "telephone_number": "574-952-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11559 CUMBERLAND RD",
            "address_2": "SUITE 100",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379784",
            "telephone_number": "317-579-5400",
            "fax_number": "317-579-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZ",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012356A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.