Individual provider Active NPI

Heath W Jones, D.D.S.

  • General Practice Dentistry
  • Lafayette, IN
National Provider Identifier
1366532079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009872 Issued in IN
Practice address
114 Executive Dr
Suite B
Lafayette, IN 47905-4883
Phone
(765) 447-2725
Fax
(765) 448-3966
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

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 12009872 IN Primary

Addresses

Primary practice location

114 Executive Dr
Suite B
Lafayette, IN 47905-4883

Mailing address

5305 S 800 E
Lafayette, IN 47905-7731
Phone (765) 447-2725

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
I20191226000709 IN Order and Referring Only - DentistPractitioner - Dentist 9335444744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009872INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Dental Group, PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366532079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 S 800 E",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479057731",
            "telephone_number": "765-447-2725",
            "fax_number": "765-448-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 EXECUTIVE DR",
            "address_2": "SUITE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054883",
            "telephone_number": "765-447-2725",
            "fax_number": "765-448-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "HEATH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.