Individual provider Active NPI

Matthew J Bueter, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1316235344
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011628A Issued in IN
Practice address
6919 E 10TH St
# A1
Indianapolis, IN 46219-4893
Phone
(317) 358-8885
Fax
(317) 358-8886
NPI assigned
Jul 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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 12011628A IN Primary

Addresses

Primary practice location

6919 E 10TH St
# A1
Indianapolis, IN 46219-4893

Mailing address

6919 E 10TH St
# A1
Indianapolis, IN 46219-4893
Phone (317) 358-8885

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
I20150504000185 IN Order and Referring Only - DentistPractitioner - Dentist 6305165986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011628AINMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1316235344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6919 E 10TH ST",
            "address_2": "# A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194893",
            "telephone_number": "317-358-8885",
            "fax_number": "317-358-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 E 10TH ST",
            "address_2": "# A1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194893",
            "telephone_number": "317-358-8885",
            "fax_number": "317-358-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUETER",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011628A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.