Individual provider Active NPI

David Wayne Austin, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1306852322
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009386A Issued in IN
Practice address
5660 Eden Village Dr
Indianapolis, IN 46254-1294
Phone
(317) 297-9750
Fax
(317) 297-7169
NPI assigned
Jul 31, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009386A IN Primary

Addresses

Primary practice location

5660 Eden Village Dr
Indianapolis, IN 46254-1294

Mailing address

5660 Eden Village Dr
Indianapolis, IN 46254-1294
Phone (317) 297-9750

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
I20161228001397 IN Order and Referring Only - DentistPractitioner - Dentist 5092096396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009386AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pike Family Dentistry General Practice Past Accepting new patients
Ruggs Dancy Dental LLC PastSince Apr 28, 2024 Accepting new patients

Organizations & group practices 2

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306852322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5660 EDEN VILLAGE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541294",
            "telephone_number": "317-297-9750",
            "fax_number": "317-297-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5660 EDEN VILLAGE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541294",
            "telephone_number": "317-297-9750",
            "fax_number": "317-297-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009386A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.