Individual provider Active NPI

Steven Charles Salkeld, D.D.S.

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1851353601
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009491 Issued in IN
Practice address
12962 Coldwater Road
Fort Wayne, IN 46845
Phone
(260) 637-4648
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7966 AZ
General Practice Dentistry 1223G0001X 12009491 IN Primary

Addresses

Primary practice location

12962 Coldwater Road
Fort Wayne, IN 46845

Mailing address

12962 Coldwater Road
Fort Wayne, IN 46845
Phone (260) 446-8715

Other identifiers 1

IdentifierTypeStateIssuer
525312MedicaidAZ

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
I20190919001205 IN Order and Referring Only - DentistPractitioner - Dentist 9133437841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7966AZMDGeneral Practice Dentistry
12009491INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Salkeld Family Dental, LLC CurrentSince Sep 27, 2020 Accepting new patients
Bertsch Family Dentistry LLC PastSince Oct 2, 2022 Accepting new patients

Locations

12962 Coldwater Rd
Fort Wayne, IN 46845
Phone (260) 637-4648

10540 Coldwater Rd
Fort Wayne, IN 46845
Phone (260) 637-4648

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1851353601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12962 COLDWATER ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-446-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12962 COLDWATER ROAD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-637-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALKELD",
        "first_name": "STEVEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7966",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "525312",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.