Active NPI
David P Pflum, D.D.S.
- Endodontics
- Mishawaka, IN
National Provider Identifier
1578781001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 12011293A
- Practice address
- 812 W Edison Rd
Mishawaka, IN 46545-2744 - Phone
- (574) 256-2739
- NPI assigned
- Apr 22, 2007
- Last updated
- Dec 30, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.027205 | IL | |
| Dentist | 122300000X | 8501 | KY | |
| Endodontics | 1223E0200X | 12011293A | IN | Primary |
Addresses
Primary practice location
812 W Edison Rd
Mishawaka, IN 46545-2744
Mailing address
812 W Edison Rd
Mishawaka, IN 46545
Phone (574) 256-2739
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140723001332 | IN | Order and Referring Only - Oral Surgery | 9537385877 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.027205 | IL | MD | Dentist |
| 8501 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blum Chiropractic LLC | 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": "1177200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325203200000",
"number": "1578781001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 W EDISON RD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "46545",
"telephone_number": "574-256-2739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 W EDISON RD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465452744",
"telephone_number": "574-256-2739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFLUM",
"first_name": "DAVID",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-22",
"last_updated": "2011-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.027205",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "8501",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IN",
"license": "12011293A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
- Bailey Personette, RD, CD
- Matthew Bain Petersen, DPT
- Lauren Rose Peterson
- Cindy Petzke, NURSE PRACTITIONER
- Tracy Jeannine Pfaffenberger, R.D., C.D.
- Michael James Phend, M.D.
- Sheila Lynne Phillips, FNP
- Phoenix Counseling Services, Incorporated
- Physicians Holistic Health Alliance, LLC
- Physicians Hospital, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.