Active NPI
Mai Linh T Regan, D.M.D.
- Dentist
- Goshen, IN
National Provider Identifier
1730483587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12013660A
- Practice address
- 3560 Elkhart Rd
Goshen, IN 46526-5814 - Phone
- (574) 875-7711
- NPI assigned
- Jan 7, 2011
- Last updated
- Oct 24, 2022
- Sex
- Female
- 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 | 12013660A | IN | Primary |
Addresses
Primary practice location
3560 Elkhart Rd
Goshen, IN 46526-5814
Mailing address
51208 Radcliffe CT
South Bend, IN 46637-6046
Phone (617) 504-8718
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12013660A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Trusted Dentistry, P.C. | Current | Accepting new patients | |
| Ambiance Dental, LLC. | Dentist | Past | Accepting new patients |
Locations
3560 Elkhart Rd
Goshen, IN 46526
Phone (574) 875-7711
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Tyngsboro, MA
- NPI 1689888232
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1730483587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51208 RADCLIFFE CT",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466376046",
"telephone_number": "617-504-8718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3560 ELKHART RD",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465265814",
"telephone_number": "574-875-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGAN",
"first_name": "MAI LINH",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-07",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12013660A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.