Mary Elizabeth Sheehan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009495 Issued in IN

Practice address

2204 S Park Ave
Alexandria, IN 46001-8059

Phone

(765) 724-7729

Fax

(765) 724-9519

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mary Elizabeth Sheehan D.D.S., P.C.

  • General Practice Dentistry
  • Knightstown, IN
  • NPI 1447329735
  NPD (past) Authorized official
• Kluth Family Dentistry Inc.

  • General Practice Dentistry
  • Alexandria, IN
  • NPI 1053402198
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1689753279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6267 RED FOX RD",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460649058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S PARK AVE",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460018059",
            "telephone_number": "765-724-7729",
            "fax_number": "765-724-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216230A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Torie Lynn Richardson, DDS
• Keeton Ann Rogers, RBT
• Jeffery Ross, NRP
• Saint John'S Health System
• Mandalai Rose Seay
• Elaine Deanne Showalter, RN
• Kathy Ann Sizelove, LICENSED HEARING SP.
• Jessica Halie Stewart, RBT
• Amanda R Tucker, FNP-C
• Kelly Williams

• General Practice Dentistry in Alexandria, IN
• Providers in Alexandria, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.

Verify at the official NPI Registry.