Individual provider Active NPI

Jim D. Frankos, D.D.S.

  • General Practice Dentistry
  • Munster, IN
National Provider Identifier
1336217512
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009561 Issued in IN
Practice address
805 Ridge Rd
2ND Floor
Munster, IN 46321-1719
Phone
(219) 836-4747
Fax
(219) 836-4726
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 12009561 IN Primary

Addresses

Primary practice location

805 Ridge Rd
2ND Floor
Munster, IN 46321-1719

Mailing address

805 Ridge Rd
2ND Floor
Munster, IN 46321-1719
Phone (219) 836-4747

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
I20160608002022 IN Order and Referring Only - DentistPractitioner - Dentist 6002106788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009561INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336217512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 RIDGE RD",
            "address_2": "2ND FLOOR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211719",
            "telephone_number": "219-836-4747",
            "fax_number": "219-836-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 RIDGE RD",
            "address_2": "2ND FLOOR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211719",
            "telephone_number": "219-836-4747",
            "fax_number": "219-836-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKOS",
        "first_name": "JIM",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.