Active NPI
Miles D Schroeder, DDS
- General Practice Dentistry
- Indianapolis, IN
National Provider Identifier
1447397765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7381
- Practice address
- 8028 E 10TH St
Suite C
Indianapolis, IN 46219-5242 - Phone
- (317) 897-8028
- Fax
- (317) 897-8025
- NPI assigned
- Jan 30, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7381 | IN | Primary |
Addresses
Primary practice location
8028 E 10TH St
Suite C
Indianapolis, IN 46219-5242
Mailing address
8028 E 10TH St
Suite C
Indianapolis, IN 46219-5242
Phone (317) 897-8028
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200190760 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2015 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7381 | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miles D. Schroeder and Geralyn M. Schroeder, P.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Indianapolis, IN
- NPI 1194105502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447397765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8028 E 10TH ST",
"address_2": "SUITE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462195242",
"telephone_number": "317-897-8028",
"fax_number": "317-897-8025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8028 E 10TH ST",
"address_2": "SUITE C",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462195242",
"telephone_number": "317-897-8028",
"fax_number": "317-897-8025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "MILES",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "7381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200190760",
"state": "IN"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.