Individual provider Active NPI

Jeffery D Flatt, DDS

  • General Practice Dentistry
  • New Albany, IN
National Provider Identifier
1235219544
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
IN8385 Issued in IN
Practice address
1919 State St Ste 208
New Albany, IN 47150-6805
Phone
(812) 944-7874
Fax
(812) 944-7930
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 8385 IN
General Practice Dentistry 1223G0001X IN8385 IN Primary

Addresses

Primary practice location

1919 State St Ste 208
New Albany, IN 47150-6805

Mailing address

1919 State St
Ste 208
New Albany, IN 47150
Phone (812) 944-7874

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
I20170316000451 IN Order and Referring Only - DentistPractitioner - Dentist 8224313150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IN8385INMDGeneral Practice Dentistry
8385INMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1235219544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 STATE ST",
            "address_2": "STE 208",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "47150",
            "telephone_number": "812-944-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE ST STE 208",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506805",
            "telephone_number": "812-944-7874",
            "fax_number": "812-944-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLATT",
        "first_name": "JEFFERY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "8385",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "IN8385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.