Active NPI
Alexander Charles Hubrecht, DMD
- Pediatric Dentistry
- Fishers, IN
National Provider Identifier
1184319337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12014594A
- Practice address
- 9126 Technology LN Ste 100
Fishers, IN 46038-3094 - Phone
- (317) 598-9898
- NPI assigned
- Apr 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 12014594A | IN | Primary |
Addresses
Primary practice location
9126 Technology LN Ste 100
Fishers, IN 46038-3094
Mailing address
307 N Pennsylvania St Apt 514
Indianapolis, IN 46204-2293
Phone (317) 730-5014
Other practice location 1
6900 Forest Ave Ste 110
Richmond, VA 23230-1730
Phone (804) 893-8715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300102462 | Medicaid | IN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12014594A | IN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1184319337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 N PENNSYLVANIA ST APT 514",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462042293",
"telephone_number": "317-730-5014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9126 TECHNOLOGY LN STE 100",
"city": "FISHERS",
"state": "IN",
"postal_code": "460383094",
"telephone_number": "317-598-9898"
}
],
"practiceLocations": [
{
"address_1": "6900 Forest Ave Ste 110",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232301730",
"country_code": "US",
"telephone_number": "804-893-8715",
"fax_number": "804-285-1292",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUBRECHT",
"first_name": "ALEXANDER",
"middle_name": "CHARLES",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-05",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12014594A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300102462",
"state": "IN"
}
],
"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 Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.