Individual provider Active NPI

Shalabh Chauhan, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1497290043
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12013056A Issued in IN
Practice address
2536 E 10TH St
Indianapolis, IN 46201-2155
Phone
(317) 983-1200
Fax
(317) 983-1201
NPI assigned
Jan 5, 2017
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1001466 WI
General Practice Dentistry 1223G0001X 12013056A IN Primary

Addresses

Primary practice location

2536 E 10TH St
Indianapolis, IN 46201-2155

Mailing address

2536 E 10TH St
Indianapolis, IN 46201-2155
Phone (317) 983-1200

Other practice location 1

821 S Layton Blvd
Milwaukee, WI 53215-1225
Phone (888) 988-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20170110000437 IL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2062793896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001466WIMDDentist
12013056AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Mkemitchell LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1497290043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2536 E 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462012155",
            "telephone_number": "317-983-1200",
            "fax_number": "317-983-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 E 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462012155",
            "telephone_number": "317-983-1200",
            "fax_number": "317-983-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 S Layton Blvd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532151225",
            "country_code": "US",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-4850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUHAN",
        "first_name": "SHALABH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-05",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001466",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013056A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.