Individual provider Active NPI

Phyllis Robin Indianer, DDS

  • General Practice Dentistry
  • Rochester Hills, MI
National Provider Identifier
1780687772
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
012808 Issued in MI
Practice address
1423 Walton Blvd
Rochester Hills, MI 48309-1775
Phone
(248) 651-1555
Fax
(248) 651-0560
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 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 012808 MI Primary

Addresses

Primary practice location

1423 Walton Blvd
Rochester Hills, MI 48309-1775

Mailing address

5240 Provincial Dr
Bloomfield Hills, MI 48302-2533
Phone (248) 851-5405

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
012808MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780687772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 PROVINCIAL DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483022533",
            "telephone_number": "248-851-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 WALTON BLVD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091775",
            "telephone_number": "248-651-1555",
            "fax_number": "248-651-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDIANER",
        "first_name": "PHYLLIS",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "012808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.