NPIMap

Organization Active NPI

Jasper Family Dentistry P.C.

  • Dentist
  • Jasper, IN
National Provider Identifier
1215312319
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011481A Issued in IN
Legal business name
JASPER FAMILY DENTISTRY P.C.
Practice address
715 Macarthur St
Jasper, IN 47546-2621
Phone
(812) 482-6610
Fax
(812) 634-6610
NPI assigned
Jul 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

Name
Chris Drake
Title
Office Manager
Phone
(812) 482-6610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12011481A IN Primary

Addresses

Primary practice location

715 Macarthur St
Jasper, IN 47546-2621

Mailing address

715 Macarthur St
Jasper, IN 47546-2621
Phone (812) 482-6610

National Provider Directory

National Provider Directory

Locations

715 MacArthur St
Jasper, IN 47546
Phone (812) 482-6610

Practitioners & affiliated clinicians

Practitioners 1

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": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1215312319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MACARTHUR ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462621",
            "telephone_number": "812-482-6610",
            "fax_number": "812-634-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MACARTHUR ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475462621",
            "telephone_number": "812-482-6610",
            "fax_number": "812-634-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER FAMILY DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "812-482-6610"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011481A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.