Individual provider Active NPI

Jane Jian Chen, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1801819644
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010255A Issued in IN
Practice address
4715 Statesmen Dr
Suite E
Indianapolis, IN 46250-5642
Phone
(317) 578-9696
Fax
(317) 578-9797
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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 12010255A IN Primary

Addresses

Primary practice location

4715 Statesmen Dr
Suite E
Indianapolis, IN 46250-5642

Mailing address

4715 Statesmen Dr
Suite E
Indianapolis, IN 46250-5642
Phone (317) 578-9696

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
I20150618000567 IN Order and Referring Only - DentistPractitioner - Dentist 3971814823

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1801819644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 STATESMEN DR",
            "address_2": "SUITE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505642",
            "telephone_number": "317-578-9696",
            "fax_number": "317-578-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 STATESMEN DR",
            "address_2": "SUITE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505642",
            "telephone_number": "317-578-9696",
            "fax_number": "317-578-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JANE",
        "middle_name": "JIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010255A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.