Individual provider Active NPI

Julie Lynn Combs, DDS MS

  • Periodontics
  • Greenfield, IN
National Provider Identifier
1194056697
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12011410A Issued in IN
Practice address
120 W McKenzie Rd
J
Greenfield, IN 46140-3084
Phone
(317) 477-3000
Fax
(317) 477-3002
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 12011410A IN Primary
Dentist 122300000X 0401412355 VA
Dentist 122300000X 8302 KY

Addresses

Primary practice location

120 W McKenzie Rd
J
Greenfield, IN 46140-3084

Mailing address

120 W McKenzie Rd
J
Greenfield, IN 46140-3084
Phone (317) 477-3000

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
I20160422001486 IN Order and Referring Only - DentistPractitioner - Dentist 1456657741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8302KYMDDentist
0401412355VAMDDentist
12011410AINMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1194056697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MCKENZIE RD",
            "address_2": "J",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461403084",
            "telephone_number": "317-477-3000",
            "fax_number": "317-477-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MCKENZIE RD",
            "address_2": "J",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461403084",
            "telephone_number": "317-477-3000",
            "fax_number": "317-477-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBS",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12011410A",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412355",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

Verify at the official NPI Registry.