Individual provider Active NPI

Jeffrey Alan Platt, D.D.S.

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1366472425
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12008605A Issued in IN
Practice address
3750 Guion Rd Ste 215
Indianapolis, IN 46222-1669
Phone
(317) 408-8709
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X 12008605A IN Primary

Addresses

Primary practice location

3750 Guion Rd Ste 215
Indianapolis, IN 46222-1669

Mailing address

7817 N Chester Ave
Indianapolis, IN 46240-3408
Phone (317) 408-2675

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
I20151014002421 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042529000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008605AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366472425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7817 N CHESTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403408",
            "telephone_number": "317-408-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 GUION RD STE 215",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221669",
            "telephone_number": "317-408-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLATT",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008605A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.