Individual provider Active NPI

Rodney J. Eccles, D.D.S.

  • General Practice Dentistry
  • Plainfield, IN
National Provider Identifier
1649283169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008688 Issued in IN
Practice address
1858 Stafford Rd
Plainfield, IN 46168-2339
Phone
(317) 839-4100
Fax
(317) 839-7874
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12008688 IN Primary

Addresses

Primary practice location

1858 Stafford Rd
Plainfield, IN 46168-2339

Mailing address

1858 Stafford Rd
Plainfield, IN 46168-2339
Phone (317) 839-4100

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150513002088 IN Order and Referring Only - DentistPractitioner - Dentist 3173843224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008688INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649283169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 STAFFORD RD",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682339",
            "telephone_number": "317-839-4100",
            "fax_number": "317-839-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 STAFFORD RD",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682339",
            "telephone_number": "317-839-4100",
            "fax_number": "317-839-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECCLES",
        "first_name": "RODNEY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IN

Sources for this page

Verify at the official NPI Registry.