Active NPI
Derek Todd Corn, DDS
- General Practice Dentistry
- Edinburgh, IN
National Provider Identifier
1295220010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12012950A
- Practice address
- 206 S Main St
Edinburgh, IN 46124-1337 - Phone
- (812) 220-2676
- NPI assigned
- Jun 25, 2018
- Last updated
- Mar 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12012950A | IN | Primary |
Addresses
Primary practice location
206 S Main St
Edinburgh, IN 46124-1337
Mailing address
206 S Main St
Edinburgh, IN 46124-1337
Phone (812) 381-1525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012950A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edinburgh Dental Care, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1295220010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 S MAIN ST",
"city": "EDINBURGH",
"state": "IN",
"postal_code": "461241337",
"telephone_number": "812-381-1525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 S MAIN ST",
"city": "EDINBURGH",
"state": "IN",
"postal_code": "461241337",
"telephone_number": "812-220-2676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORN",
"first_name": "DEREK",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-25",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12012950A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edinburgh, IN
- American Health Network of Indiana, LLC
- Roger T Ata
- Lisa D Bell, APRN
- Helen-Louise Boling, CPNP
- Kevin Michael Conlee, PH.D. HSPP
- Shawn Davidson, COTA/L
- Dr Mark W Smith DDS LLC
- Edinburgh Chiropractic LLC (Sweet Chiropractic)
- Edinburgh Community School Corporation
- Edinburgh Dental Care, PC (Corn Family Dentistry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.