Individual provider Active NPI

Jeffrey Alan Mishler, D.D.S.

  • General Practice Dentistry
  • Greenwood, IN
National Provider Identifier
1184634404
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008125B Issued in IN
Practice address
701 N Madison Ave
Greenwood, IN 46142-4126
Phone
(317) 881-4305
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12008125B IN Primary

Addresses

Primary practice location

701 N Madison Ave
Greenwood, IN 46142-4126

Mailing address

PO Box 216
Greenwood, IN 46142-0216
Phone (317) 881-4305

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
I20160202000451 IN Order and Referring Only - DentistPractitioner - Dentist 8325342918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008125BINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Ave Dental LLC Past 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184634404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461420216",
            "telephone_number": "317-881-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461424126",
            "telephone_number": "317-881-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHLER",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008125B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.