Individual provider Active NPI

Bryan Allen Seyferth, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1659515666
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12010376A Issued in IN
Practice address
2620 E 62ND St
Indianapolis, IN 46220-2934
Phone
(317) 251-2371
Fax
(317) 333-6446
NPI assigned
Apr 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12010376A IN Primary

Addresses

Primary practice location

2620 E 62ND St
Indianapolis, IN 46220-2934

Mailing address

2620 E 62ND St
Indianapolis, IN 46220-2934
Phone (317) 251-2371

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
12010376AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1659515666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E 62ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202934",
            "telephone_number": "317-251-2371",
            "fax_number": "317-333-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 E 62ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462202934",
            "telephone_number": "317-251-2371",
            "fax_number": "317-333-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYFERTH",
        "first_name": "BRYAN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010376A",
            "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 Apr 22, 2009; 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.