NPIMap

Individual provider Active NPI

Teerthesh Jain, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1366072936
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013524A Issued in IN
Practice address
8028 S Emerson Ave Ste a
Indianapolis, IN 46237-9301
Phone
(317) 893-2657
NPI assigned
Jan 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032478 IL
Dentist 122300000X DEN.00204264 CO
Dentist 122300000X 35921 TX
General Practice Dentistry 1223G0001X DEN.00204264 CO
Dentist 122300000X 12013524A IN Primary

Addresses

Primary practice location

8028 S Emerson Ave Ste a
Indianapolis, IN 46237-9301

Mailing address

13335 Fielding Way
Fishers, IN 46037-4612
Phone (720) 454-9057

Other practice location 1

10706 E US Hyw 36
Avon, IN 46123
Phone (720) 454-9057

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.032478ILMDDentist
12013524AINMDDentist
DEN.00204264COMDGeneral Practice Dentistry
35921TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Dental General Practice PastSince Jan 1, 2020 Accepting new patients
Port Arthur Smiles Inc Dentist PastSince Jun 1, 2020 Accepting new patients
Global Smiles Dental Dentist PastSince Jan 3, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teerthesh.jain.p30@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1366072936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13335 FIELDING WAY",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374612",
            "telephone_number": "720-454-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 S EMERSON AVE STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379301",
            "telephone_number": "317-893-2657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10706 E US Hyw 36",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "46123",
            "country_code": "US",
            "telephone_number": "720-454-9057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "TEERTHESH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032478",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35921",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013524A",
            "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 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.