Individual provider Active NPI

Jared Benjamin Siegel, DDS

  • General Practice Dentistry
  • Schererville, IN
National Provider Identifier
1740818848
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032902 Issued in IL
Practice address
41 US Highway 41
Schererville, IN 46375-1201
Phone
(219) 336-8571
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.032902 IL Primary
General Practice Dentistry 1223G0001X 12013641A IN

Addresses

Primary practice location

41 US Highway 41
Schererville, IN 46375-1201

Mailing address

205 S Peoria St Apt 1219
Chicago, IL 60607-3129
Phone (631) 374-8567

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
019.032902ILMDGeneral Practice Dentistry
12013641AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jared B Siegel DDS PC General Practice CurrentSince Jul 31, 2022 Accepting new patients

Locations

41 US Highway 41
Schererville, IN 46375
Phone (219) 250-1762

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.

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1740818848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S PEORIA ST APT 1219",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073129",
            "telephone_number": "631-374-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 US HIGHWAY 41",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751201",
            "telephone_number": "219-336-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JARED",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032902",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013641A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.