Brian Christopher McLellan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12011988A Issued in IN

Practice address

520 W Main St
Greentown, IN 46936-1021

Phone

(765) 628-3770

NPI assigned

Jul 29, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1912349127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W MAIN ST",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469361021",
            "telephone_number": "765-628-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W MAIN ST",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469361021",
            "telephone_number": "765-628-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "BRIAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011988A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith E Lausch, RN, RA
• Jessica A Libey
• Colten Lorenz, DC
• Heather Maher, SLP
• Whitney McCammon
• Sarah McNutt, SLP
• Memory Care Consulting in
• Jessica Joan Miller, MACCC-SLP
• Kathleen Julia Montoya, B.S. SLHS
• Kimberly Hall Mossburg, RD, ATC

• General Practice Dentistry in Greentown, IN
• Providers in Greentown, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.