David M. Follis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12010354A Issued in IN

Practice address

1422 Lincoln Way E
South Bend, IN 46613-3250

Phone

(574) 232-8888

Fax

(574) 232-8929

NPI assigned

Sep 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Select Dentistry, PC

  • General Practice Dentistry
  • South Bend, IN
  • NPI 1811186323
  NPD (past) Authorized official
• Select Dental Associates PC

  • General Practice Dentistry
  • South Bend, IN
  • NPI 1457850687
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1457345688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21061 QUIET RIDGE CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466145181",
            "telephone_number": "574-514-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 LINCOLN WAY E",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466133250",
            "telephone_number": "574-232-8888",
            "fax_number": "574-232-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLLIS",
        "first_name": "DAVID",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010354A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200214390",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• FMS Nephrology Partners North Central Indiana Dialysis Centers, LLC
• Alaina Focosi
• Focused Eye Care LLC
• Cynthia Susan Fodness, CNS
• Nicole Dawnyale Foley
• Gionni Carlitto Fonseca
• Shayla Fonseca
• Derrick Forchetti, M.D.
• Garrett Ford
• Juilann Marie Ford, M.A., CCCSLP

• Dentist in South Bend, IN
• Providers in South Bend, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.