Philip Clifford Rake, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12006818A Issued in IN

Practice address

11405 N Pennsylvania St
Suite 110
Carmel, IN 46032

Phone

(317) 569-1120

Fax

(317) 569-1120

NPI assigned

Apr 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225151368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 N PENNSYLVANIA ST",
            "address_2": "SUITE 110",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "317-569-1120",
            "fax_number": "317-569-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11405 N PENNSYLVANIA ST",
            "address_2": "SUITE 110",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "317-569-1120",
            "fax_number": "317-569-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKE",
        "first_name": "PHILIP",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12006818A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Carmel, IN
• Providers in Carmel, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.