Individual provider Active NPI

Jerry Edward Lambert Jr., DDS

  • Dentist
  • Crown Point, IN
National Provider Identifier
1871519777
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12009409 Issued in IN
Practice address
301 S Court St
Crown Point, IN 46307
Phone
(219) 663-1207
Fax
(219) 663-6474
NPI assigned
Jul 14, 2006
Last updated
Sep 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12009409 IN Primary

Addresses

Primary practice location

301 S Court St
Crown Point, IN 46307

Mailing address

301 S Court St
Crown Point, IN 46307
Phone (219) 663-1207

Other identifiers 1

IdentifierTypeStateIssuer
100202550AMedicaidIN

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
I20111020000408 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214109057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009409INMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jerry E. Lambert, Jr., D.D.S., P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1871519777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S COURT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "46307",
            "telephone_number": "219-663-1207",
            "fax_number": "219-663-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S COURT ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "46307",
            "telephone_number": "219-663-1207",
            "fax_number": "219-663-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "JERRY",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100202550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.