Individual provider Active NPI

Troy Roger Springer, D.M.D.

  • Dentist
  • Elkhart, IN
National Provider Identifier
1184851164
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011330A Issued in IN
Practice address
3702 E Mishawaka Rd
Elkhart, IN 46517-3550
Phone
(574) 875-6595
NPI assigned
Jun 17, 2009
Last updated
Oct 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011330A IN Primary

Addresses

Primary practice location

3702 E Mishawaka Rd
Elkhart, IN 46517-3550

Mailing address

3702 E Mishawaka Rd
Elkhart, IN 46517-3550
Phone (574) 875-6595

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
I20110628000780 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860670569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011330AINMDDentist

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1184851164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 E MISHAWAKA RD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465173550",
            "telephone_number": "574-875-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 E MISHAWAKA RD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465173550",
            "telephone_number": "574-875-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRINGER",
        "first_name": "TROY",
        "middle_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011330A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.