Organization Active NPI

Yoder/Rahrig Family Dentistry

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1538189063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6051 Issued in IN
Legal business name
YODER/RAHRIG FAMILY DENTISTRY
Practice address
333 E Tillman Rd
Fort Wayne, IN 46816-1017
Phone
(260) 447-1776
Fax
(260) 447-6530
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Keith E Yoder, DDS
Title
Dentist
Phone
(260) 447-1776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6051 IN Primary

Addresses

Primary practice location

333 E Tillman Rd
Fort Wayne, IN 46816-1017

Mailing address

333 E Tillman Rd
Fort Wayne, IN 46816-1017
Phone (260) 447-1776

Other identifiers 1

IdentifierTypeStateIssuer
851799OtherINUNITED CONCORDIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538189063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E TILLMAN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468161017",
            "telephone_number": "260-447-1776",
            "fax_number": "260-447-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E TILLMAN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468161017",
            "telephone_number": "260-447-1776",
            "fax_number": "260-447-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YODER/RAHRIG FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "260-447-1776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "6051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "851799",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.