Susan E Snyder DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009083 Issued in IN

Legal business name

SUSAN E SNYDER DDS, PC

Practice address

750 Park East Blvd
Suite 5
Lafayette, IN 47905-0788

Phone

(765) 447-7878

Fax

(765) 449-0665

NPI assigned

Dec 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Susan E Snyder

Title

Owner

Phone

(765) 447-7878

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1386009785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 PARK EAST BLVD",
            "address_2": "SUITE 5",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050788",
            "telephone_number": "765-447-7878",
            "fax_number": "765-449-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 PARK EAST BLVD",
            "address_2": "SUITE 5",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479050788",
            "telephone_number": "765-447-7878",
            "fax_number": "765-449-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN E SNYDER DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-447-7878",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.