Individual provider Active NPI

Michelle Tissot Ebeyer, D.D.S

  • General Practice Dentistry
  • Greenwood, IN
National Provider Identifier
1821188673
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010147A Issued in IN
Practice address
973 Emerson Pkwy
Suite a
Greenwood, IN 46143-6906
Phone
(317) 883-3368
Fax
(317) 883-3120
NPI assigned
Oct 13, 2006
Sex
Female
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
General Practice Dentistry 1223G0001X 12010147A IN Primary

Addresses

Primary practice location

973 Emerson Pkwy
Suite a
Greenwood, IN 46143-6906

Mailing address

973 Emerson Pkwy
Suite a
Greenwood, IN 46143-6906
Phone (317) 883-3368

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12010147AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
A Dental Touch LLC Past Accepting new patients
Major Hospital Past Accepting new patients

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821188673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "973 EMERSON PKWY",
            "address_2": "SUITE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436906",
            "telephone_number": "317-883-3368",
            "fax_number": "317-883-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "973 EMERSON PKWY",
            "address_2": "SUITE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436906",
            "telephone_number": "317-883-3368",
            "fax_number": "317-883-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEYER",
        "first_name": "MICHELLE",
        "middle_name": "TISSOT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010147A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.