Individual provider Active NPI

Jay Alan Hollander, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1184778268
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007775A Issued in IN
Practice address
1255 W 86TH St
Indianapolis, IN 46260-2203
Phone
(317) 259-1501
Fax
(317) 259-1543
NPI assigned
Jan 23, 2007
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 12007775A IN Primary

Addresses

Primary practice location

1255 W 86TH St
Indianapolis, IN 46260-2203

Mailing address

1255 W 86TH St
Indianapolis, IN 46260-2203
Phone (317) 259-1501

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
I20160108000282 IN Order and Referring Only - DentistPractitioner - Dentist 9032411061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12007775AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jay a. Hollander, D.D.S., P.C. General Practice 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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184778268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602203",
            "telephone_number": "317-259-1501",
            "fax_number": "317-259-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602203",
            "telephone_number": "317-259-1501",
            "fax_number": "317-259-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "JAY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007775A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.