Active NPI
Amish Dushyant Pandya, DMD
- Dentist
- Munster, IN
National Provider Identifier
1508856980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011539A
- Practice address
- 9335 Calumet Ave
Suite a
Munster, IN 46321-4175 - Phone
- (219) 836-2092
- Fax
- (219) 836-9501
- NPI assigned
- Oct 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12011539A | IN | Primary |
Addresses
Primary practice location
9335 Calumet Ave
Suite a
Munster, IN 46321-4175
Mailing address
9335 Calumet Ave
Suite a
Munster, IN 46321-4175
Phone (219) 836-2092
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201048300 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210106003036 | OH | Order and Referring Only - Dentist | 1153734314 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011539A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastman Dental | Past | Accepting new patients | |
| Nothing But the Tooth LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Munster, IN
- NPI 1497147086
-
- General Practice Dentistry
- Munster, IN
- NPI 1396389110
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1508856980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9335 CALUMET AVE",
"address_2": "SUITE A",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463214175",
"telephone_number": "219-836-2092",
"fax_number": "219-836-9501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9335 CALUMET AVE",
"address_2": "SUITE A",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463214175",
"telephone_number": "219-836-2092",
"fax_number": "219-836-9501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDYA",
"first_name": "AMISH",
"middle_name": "DUSHYANT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-26",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12011539A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201048300",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.