Individual provider Active NPI

Dennis W. Lamp, D.D.S.

  • General Practice Dentistry
  • Avilla, IN
National Provider Identifier
1700990686
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007359A Issued in IN
Practice address
2235 S 825 E
Avilla, IN 46710-9735
Phone
(260) 897-2555
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 12007359A IN Primary

Addresses

Primary practice location

2235 S 825 E
Avilla, IN 46710-9735

Mailing address

2235 S 825 E
Avilla, IN 46710-9735
Phone (260) 897-2555

Other identifiers 1

IdentifierTypeStateIssuer
100190800MedicaidIN

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
I20160829001861 IN Order and Referring Only - DentistPractitioner - Dentist 7315232402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1700990686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 S 825 E",
            "city": "AVILLA",
            "state": "IN",
            "postal_code": "467109735",
            "telephone_number": "260-897-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 S 825 E",
            "city": "AVILLA",
            "state": "IN",
            "postal_code": "467109735",
            "telephone_number": "260-897-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMP",
        "first_name": "DENNIS",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007359A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100190800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avilla, IN

Sources for this page

Verify at the official NPI Registry.