NPIMap

Organization Active NPI

Charles H Middleton DDS PC

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1215024989
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHARLES H MIDDLETON DDS PC
Practice address
4302 E State Blvd
Fort Wayne, IN 46815
Phone
(260) 484-3136
Fax
(260) 484-3137
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Charles H Middleton, DDS PCNPI 1093902264
Title
Owner
Phone
(260) 484-3136

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4302 E State Blvd
Fort Wayne, IN 46815

Mailing address

4302 E State Blvd
Fort Wayne, IN 46815
Phone (260) 484-3136

Other identifiers 1

IdentifierTypeStateIssuer
00055165OtherINUNITED CONCORDIA

Other names 1

  • Charles H Middleton & Mary Ellen Argus Other name

National Provider Directory

National Provider Directory

Locations

4302 E State Blvd
Fort Wayne, IN 46815
Phone (260) 483-0052

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1215024989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-484-3136",
            "fax_number": "260-484-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46815",
            "telephone_number": "260-484-3136",
            "fax_number": "260-484-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES H MIDDLETON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-484-3136",
        "authorized_official_credential": "DDS PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "00055165",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles H Middleton & Mary Ellen Argus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.