Individual provider Active NPI

Kevin D Ward, D.D.S.

  • General Practice Dentistry
  • Fishers, IN
National Provider Identifier
1750478533
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008832 Issued in IN
Practice address
11959 Lakeside Dr
Fishers, IN 46038-1316
Phone
(317) 577-1911
Fax
(317) 576-8070
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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 12008832 IN Primary

Addresses

Primary practice location

11959 Lakeside Dr
Fishers, IN 46038-1316

Mailing address

11959 Lakeside Drive
Fishers, IN 46038-1316
Phone (317) 577-1911

Other practice location 1

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

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
I20150504002391 IN Order and Referring Only - DentistPractitioner - Dentist 7618296153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008832INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fishers Dental Care, P.C. PastSince Jul 5, 2001 Accepting new patients

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1750478533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11959 LAKESIDE DRIVE",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460381316",
            "telephone_number": "317-577-1911",
            "fax_number": "317-576-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11959 LAKESIDE DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460381316",
            "telephone_number": "317-577-1911",
            "fax_number": "317-576-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.