Individual provider Active NPI

Scott D Hewitt, DDS

  • General Practice Dentistry
  • Elkhart, IN
National Provider Identifier
1780710467
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007801A Issued in IN
Practice address
2549 Prairie St
Elkhart, IN 46517-2193
Phone
(574) 389-8300
Fax
(574) 522-7333
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 12007801A IN Primary

Addresses

Primary practice location

2549 Prairie St
Elkhart, IN 46517-2193

Mailing address

2549 Prairie St
Elkhart, IN 46517-2193
Phone (574) 389-8300

Other identifiers 1

IdentifierTypeStateIssuer
100222340MedicaidIN

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
I20151230001051 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395894802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Dental Sleep, LLC. CurrentSince Mar 7, 2009 Accepting new patients
Hewitt and Feltzer Dentistry Partnership General Practice Past Accepting new patients

Locations

518 Lincolnway W
Mishawaka, IN 46544
Phone (574) 255-5630

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1780710467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2549 PRAIRIE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172193",
            "telephone_number": "574-389-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2549 PRAIRIE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465172193",
            "telephone_number": "574-389-8300",
            "fax_number": "574-522-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "SCOTT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007801A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100222340",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.