Individual provider Active NPI

Jennifer Mohler, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1154452415
Registry record updated Apr 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53167 Issued in CA
Practice address
818 N College Ave
Indianapolis, IN 46202-3468
Phone
(323) 330-1608
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 53167 CA Primary
Dentist 122300000X 12010060A IN

Addresses

Primary practice location

818 N College Ave
Indianapolis, IN 46202-3468

Mailing address

818 N College Ave
Indianapolis, IN 46202-3468
Phone (323) 636-8984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20130626000859 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436398278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12010060AINMDDentist
53167CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Enjoy Dental, LLC PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367020800000",
    "number": "1154452415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N COLLEGE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023468",
            "telephone_number": "323-636-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N COLLEGE AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023468",
            "telephone_number": "323-330-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHLER",
        "first_name": "JENNIFER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2013-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "53167",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010060A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.