David J Mayden, D.D.S
Individual provider Active NPI General Practice Dentistry · Syracuse, IN
NPI 1649340381 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1649340381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12009251 (IN)
- Practice address
- 205 E Lynwood Dr
Syracuse, IN 46567-1945 - Phone
- (574) 457-3138
- Fax
- (574) 457-2739
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150608001358 | IN | Order and Referring Only - Other (Physician) |
2860713419 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009251 | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12009251 | IN | Yes |
Addresses
Primary practice location
205 E Lynwood Dr
Syracuse, IN 46567-1945
Mailing address
205 E Lynwood Dr
Syracuse, IN 46567-1945
Phone (574) 457-3138
Other providers in Syracuse, IN
- Jessica Lagro Losee
- Melanie Lowman
- Raetta Madriz
- Kortney A. Malone
- Mary C Baker DDS PC
- Moses Mbogo Mihingo
- Brandi Miller
- Sarah Miller
- Aceria Myers
- Alicia Nolan
All providers in Syracuse, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.