Individual provider Active NPI

Sneha Mary Mathen, DDS

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1477386258
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014490A Issued in IN
Practice address
1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone
(260) 458-2641
NPI assigned
Aug 26, 2024
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 12014490A IN Primary

Addresses

Primary practice location

1717 S Calhoun St
Fort Wayne, IN 46802-5257

Mailing address

1717 S Calhoun St
Fort Wayne, IN 46802-5257
Phone (260) 458-2641

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
I20241022001665 IN Practitioner - Dentist 3274065701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Clinics, Inc General Practice CurrentSince Sep 1, 2024 Accepting new patients
Neighborhood Health Clinics, Inc General Practice CurrentSince Sep 1, 2024 Accepting new patients

Locations

1717 S Calhoun St
Fort Wayne, IN 46802
Phone (260) 458-2641

Interoperability endpoints

  • Direct secure messaging: sneha.mathen@nhci.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1477386258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEN",
        "first_name": "SNEHA MARY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014490A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.