Claude E Willis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12006990A&B Issued in IN

Practice address

5938 W State Road 135
Trafalgar, IN 46181-8881

Phone

(812) 597-5857

Fax

(812) 597-5847

NPI assigned

Sep 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Indian Creek Family Dentistry

  • General Practice Dentistry
  • Trafalgar, IN
  • NPI 1043879240
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245336593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5938 W STATE ROAD 135",
            "city": "TRAFALGAR",
            "state": "IN",
            "postal_code": "461818881",
            "telephone_number": "812-597-5857",
            "fax_number": "812-597-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5938 W STATE ROAD 135",
            "city": "TRAFALGAR",
            "state": "IN",
            "postal_code": "461818881",
            "telephone_number": "812-597-5857",
            "fax_number": "812-597-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "CLAUDE",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12006990A&B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Sullender
• Biak Sung, LSW
• Erica Danielle Underwood I, MS
• Mirela Ungureanu, MD
• Sarah Lynne Weber, NP-C
• Windrose Health Network Inc (Edinburgh/Trafalgar Family Health Centers, Inc)
• Windrose Health Network, Inc. (Windrose Health Network - Trafalgar)
• Windrose Health Network, Inc.
• Paul Alan Woodworth

• General Practice Dentistry in Trafalgar, IN
• Providers in Trafalgar, IN by specialty
• General Practice Dentistry 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.