Active NPI
Susan Elaine Snyder, D.D.S.
- General Practice Dentistry
- Lafayette, IN
National Provider Identifier
1821140641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12009083
- Practice address
- 750 Park East BVLD
Suite 5
Lafayette, IN 47905-0788 - Phone
- (765) 447-7878
- Fax
- (765) 449-0665
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12009083 | IN | Primary |
Addresses
Primary practice location
750 Park East BVLD
Suite 5
Lafayette, IN 47905-0788
Mailing address
750 Park East BVLD
Suite 5
Lafayette, IN 47905-0788
Phone (765) 447-7878
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12009083 | IN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1821140641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 PARK EAST BVLD",
"address_2": "SUITE 5",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479050788",
"telephone_number": "765-447-7878",
"fax_number": "765-449-0665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 PARK EAST BVLD",
"address_2": "SUITE 5",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479050788",
"telephone_number": "765-447-7878",
"fax_number": "765-449-0665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNYDER",
"first_name": "SUSAN",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12009083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.