Individual provider Active NPI

James Earl Jones, D.D.S.

  • Pediatric Dentistry
  • Indianapolis, IN
National Provider Identifier
1801959986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12007616 Issued in IN
Practice address
3737 N Meridian St
Indianapolis, IN 46208-4357
Phone
(317) 924-5359
Fax
(317) 920-4391
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12007616 IN Primary

Addresses

Primary practice location

3737 N Meridian St
Indianapolis, IN 46208-4357

Mailing address

3737 N Meridian St
Indianapolis, IN 46208-4357
Phone (317) 924-5359

Other identifiers 1

IdentifierTypeStateIssuer
100440160MedicaidIN

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
I20210426002893 IN Order and Referring Only - DentistPractitioner - Dentist 8527476886

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12007616INMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801959986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084357",
            "telephone_number": "317-924-5359",
            "fax_number": "317-920-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462084357",
            "telephone_number": "317-924-5359",
            "fax_number": "317-920-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JAMES",
        "middle_name": "EARL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12007616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100440160",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.