Robert Todd Dehaven, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12009187 Issued in IN

Practice address

2206 E 10TH St
Anderson, IN 46012-4313

Phone

(765) 640-0262

NPI assigned

Mar 16, 2007

Last updated

Sep 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1558495861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E 10TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460124313",
            "telephone_number": "765-640-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E 10TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460124313",
            "telephone_number": "765-640-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "ROBERT",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daybreak & Visiting Nurse Care, LLC
• Joanne P Dean, LCSW
• Megan Christine Deaton, NP
• Dehaven Family Dental LLC
• Angela Lynn Dehaven, DDS
• Mackenzie Dejarnatt
• Joel Brian Denis, CRNA
• Melanie Kay Denniston
• Dental Professionals of Indiana, P.C. (Anderson Family Dental)
• Courtney Rae Deshong, PT

• Dentist in Anderson, IN
• Providers in Anderson, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.