Active NPI
Bhavneet Singh
- Dentist
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12012395A
- Practice address
- 6408 W Jefferson Blvd Ste D
Fort Wayne, IN 46804-6204 - Phone
- (347) 385-1488
- NPI assigned
- Jul 17, 2015
- Last updated
- Apr 16, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12012395A | IN | Primary |
| Dentist | 122300000X | 2901600238 | MI |
Addresses
Primary practice location
6408 W Jefferson Blvd Ste D
Fort Wayne, IN 46804-6204
Mailing address
6408 W Jefferson Blvd Ste D
Fort Wayne, IN 46804-6204
Phone (347) 385-1488
Other practice location 1
4614 Coldwater Rd Ste F
Fort Wayne, IN 46825-5527
Phone (260) 666-5200
Other practice location 2
2880 Walmart Dr Unit 2920
Huntington, IN 46750-7977
Phone (260) 200-4100
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 |
|---|---|---|---|---|
| I20150924000835 | IN | Order and Referring Only - Dentist | 8628386620 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012395A | IN | MD | Dentist |
| 2901600238 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvel Dental DDS PC | Current | Accepting new patients | |
| Familia Dental Fort Wayne PLLC | Past | Accepting new patients |
Locations
4614 Coldwater Rd
Ste F
Fort Wayne, IN 46825
Phone (216) 801-2718
6408 W Jefferson Blvd
#D
Fort Wayne, IN 46804
Phone (216) 801-2718
2880 Walmart Dr
Unit 2920
Huntington, IN 46750
Phone (216) 801-2718
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Fort Wayne, IN
- NPI 1679229504
-
- General Practice Dentistry
- Newark, NJ
- NPI 1417537291
-
dba Familia Dental
- Dental Clinic/Center
- Fort Wayne, IN
- NPI 1467792663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1619351772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6408 W JEFFERSON BLVD STE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468046204",
"telephone_number": "347-385-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6408 W JEFFERSON BLVD STE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468046204",
"telephone_number": "347-385-1488"
}
],
"practiceLocations": [
{
"address_1": "4614 Coldwater Rd Ste F",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468255527",
"country_code": "US",
"telephone_number": "260-666-5200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2880 Walmart Dr Unit 2920",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "IN",
"postal_code": "467507977",
"country_code": "US",
"telephone_number": "260-200-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SINGH",
"first_name": "BHAVNEET",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-17",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12012395A",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600238",
"primary": false
}
],
"identifiers": [],
"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 Apr 16, 2024; 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.