NPIMap

Organization Active NPI

Jeffrey Golder D.D.S. P.C.

  • Dentist
  • Greenwood, IN
National Provider Identifier
1376908160
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009171 Issued in IN
Legal business name
JEFFREY GOLDER D.D.S. P.C.
Practice address
4800 W Smith Valley Rd
Ste K
Greenwood, IN 46142-9198
Phone
(317) 882-7800
Fax
(317) 883-3098
NPI assigned
Dec 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Jeffrey Golder, D.D.S.
Title
President
Phone
(317) 882-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 12009171 IN Primary

Addresses

Primary practice location

4800 W Smith Valley Rd
Ste K
Greenwood, IN 46142-9198

Mailing address

4800 W Smith Valley Rd
Ste K
Greenwood, IN 46142-9198
Phone (317) 882-7800

Other identifiers 1

IdentifierTypeStateIssuer
200279660-CMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1376908160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W SMITH VALLEY RD",
            "address_2": "STE K",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429198",
            "telephone_number": "317-882-7800",
            "fax_number": "317-883-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 W SMITH VALLEY RD",
            "address_2": "STE K",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461429198",
            "telephone_number": "317-882-7800",
            "fax_number": "317-883-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY GOLDER D.D.S. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "GOLDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-882-7800",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279660-C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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.