Active NPI
David Van Winkle
- Periodontics
- Indianapolis, IN
National Provider Identifier
1356922751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12014507A
- Practice address
- 8902 N Meridian St Ste 138
Indianapolis, IN 46260-5306 - Phone
- (317) 844-2792
- NPI assigned
- Apr 16, 2021
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12014507A | IN | Primary |
Addresses
Primary practice location
8902 N Meridian St Ste 138
Indianapolis, IN 46260-5306
Mailing address
12452 Anchorage Way
Fishers, IN 46037-9583
Phone (317) 405-7420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014507A | IN | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1356922751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12452 ANCHORAGE WAY",
"city": "FISHERS",
"state": "IN",
"postal_code": "460379583",
"telephone_number": "317-405-7420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8902 N MERIDIAN ST STE 138",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462605306",
"telephone_number": "317-844-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN WINKLE",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-16",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IN",
"license": "12014507A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.