Individual provider Active NPI

Rob Cyril Jaynes, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1588951966
Registry record updated Aug 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011720A Issued in IN
Practice address
1825 Sailing CT
Indianapolis, IN 46260-6410
Phone
(812) 360-1144
NPI assigned
Jul 6, 2011
Last updated
Aug 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011720A IN Primary

Addresses

Primary practice location

1825 Sailing CT
Indianapolis, IN 46260-6410

Mailing address

1825 Sailing CT
Indianapolis, IN 46260-6410

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170222001315 IN Order and Referring Only - DentistPractitioner - Dentist 3072897867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011720AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1588951966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SAILING CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462606410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 SAILING CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462606410",
            "telephone_number": "812-360-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYNES",
        "first_name": "ROB",
        "middle_name": "CYRIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011720A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.