Individual provider Active NPI

Mary Ellen Argus, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1164627857
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008540A Issued in IN
Practice address
6427 Georgetown North Blvd
Fort Wayne, IN 46815-7007
Phone
(260) 486-4444
NPI assigned
Jun 20, 2007
Last updated
Feb 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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 12008540A IN Primary

Addresses

Primary practice location

6427 Georgetown North Blvd
Fort Wayne, IN 46815-7007

Mailing address

1527 Sycamore Hills Pkwy
Fort Wayne, IN 46814-9343
Phone (260) 625-5424

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
I20160208000944 IN Order and Referring Only - DentistPractitioner - Dentist 6709180029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008540AINMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1164627857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 SYCAMORE HILLS PKWY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149343",
            "telephone_number": "260-625-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6427 GEORGETOWN NORTH BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157007",
            "telephone_number": "260-486-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARGUS",
        "first_name": "MARY ELLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008540A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.