Individual provider Active NPI

Jeffrey Aaron Swihart, D.D.S.

  • General Practice Dentistry
  • Elkhart, IN
National Provider Identifier
1760702906
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011431A Issued in IN
Practice address
21813 State Road 120
Elkhart, IN 46516
Phone
(574) 848-7487
Fax
(219) 548-8848
NPI assigned
Jun 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 12011431A IN Primary

Addresses

Primary practice location

21813 State Road 120
Elkhart, IN 46516

Mailing address

21813 State Road 120
Elkhart, IN 46516
Phone (574) 848-7487

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
I20150529001415 IN Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 5193045375

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1760702906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21813 STATE ROAD 120",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-848-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21813 STATE ROAD 120",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "46516",
            "telephone_number": "574-848-7487",
            "fax_number": "219-548-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIHART",
        "first_name": "JEFFREY",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011431A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.