Active NPI
Thomas John Anglemire, D.D.S.
- General Practice Dentistry
- Granger, IN
National Provider Identifier
1891825626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12009209
- Practice address
- 12545 Adams Rd
Granger, IN 46530-9226 - Phone
- (574) 277-5406
- Fax
- (574) 277-5467
- NPI assigned
- Mar 7, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 12009209 | IN | Primary |
Addresses
Primary practice location
12545 Adams Rd
Granger, IN 46530-9226
Mailing address
12545 Adams Rd
Granger, IN 46530-9226
Phone (574) 277-5406
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12009209 | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Family Dentistry, PC | General Practice | 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.
-
- General Practice Dentistry
- Granger, IN
- NPI 1619072147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891825626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12545 ADAMS RD",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309226",
"telephone_number": "574-277-5406",
"fax_number": "574-277-5467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12545 ADAMS RD",
"city": "GRANGER",
"state": "IN",
"postal_code": "465309226",
"telephone_number": "574-277-5406",
"fax_number": "574-277-5467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGLEMIRE",
"first_name": "THOMAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12009209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Granger, 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.