Individual provider Active NPI

Indre Geneviciute, DDS

  • General Practice Dentistry
  • Schererville, IN
National Provider Identifier
1639856032
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014140A Issued in IN
Practice address
1519 US Highway 41 Ste B8
Schererville, IN 46375-1373
Phone
(219) 319-0108
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12014140A IN Primary

Addresses

Primary practice location

1519 US Highway 41 Ste B8
Schererville, IN 46375-1373

Mailing address

12807 Falcon CT
Lemont, IL 60439-7300
Phone (708) 668-8840

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

LicenseStateTypeSpecialty
12014140AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Concepts LLC CurrentSince Jul 2, 2023 Accepting new patients

Locations

1519 US Highway 41
Ste B8
Schererville, IN 46375
Phone (219) 319-0108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1639856032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12807 FALCON CT",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397300",
            "telephone_number": "708-668-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 US HIGHWAY 41 STE B8",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751373",
            "telephone_number": "219-319-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENEVICIUTE",
        "first_name": "INDRE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014140A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.