Active NPI
Randall L Griffin, DDS
- General Practice Dentistry
- Noblesville, IN
National Provider Identifier
1629099916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- IN12009718
- Practice address
- 5378 E 225TH St
Noblesville, IN 46062-8147 - Phone
- (317) 409-3260
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 12009718A | IN | |
| General Practice Dentistry | 1223G0001X | IN12009718 | IN | Primary |
Addresses
Primary practice location
5378 E 225TH St
Noblesville, IN 46062-8147
Mailing address
5378 E 225TH St
Noblesville, IN 46062-8147
Phone (317) 409-3260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200139090A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009718A | IN | MD | Dentist |
| IN12009718 | IN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1629099916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5378 E 225TH ST",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460628147",
"telephone_number": "317-409-3260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5378 E 225TH ST",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460628147",
"telephone_number": "317-409-3260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "RANDALL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12009718A",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "IN12009718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200139090A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.