Active NPI
Errol Eugene Isaac Jr., DDS
- Dentist
- Indianapolis, IN
National Provider Identifier
1649343237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12010947A
- Practice address
- 3709 E Washington St
J
Indianapolis, IN 46201-4429 - Phone
- (317) 362-7893
- NPI assigned
- Nov 15, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12010947A | IN | Primary |
Addresses
Primary practice location
3709 E Washington St
J
Indianapolis, IN 46201-4429
Mailing address
6058 E 82ND St
Indianapolis, IN 46250-1530
Phone (317) 436-7341
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 |
|---|---|---|---|---|
| I20131115001095 | IN | Order and Referring Only - Oral Surgery | 6305870635 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010947A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Friendly Dentist | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Indianapolis, IN
- NPI 1184910432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612310400000",
"number": "1649343237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6058 E 82ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462501530",
"telephone_number": "317-436-7341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3709 E WASHINGTON ST",
"address_2": "J",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462014429",
"telephone_number": "317-362-7893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAAC",
"first_name": "ERROL",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2021-02-03",
"certification_date": "2021-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12010947A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.