Active NPI
Julie Lynn Combs, DDS MS
- Periodontics
- Greenfield, IN
National Provider Identifier
1194056697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12011410A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160422001486 | IN | Order and Referring Only - Dentist | 1456657741 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8302 | KY | MD | Dentist |
| 0401412355 | VA | MD | Dentist |
| 12011410A | IN | MD | Periodontist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.