Individual provider Active NPI

Robert Chenoweth, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1932303443
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011004 Issued in IN
Practice address
986 N Mitthoeffer Rd
Indianapolis, IN 46229-2622
Phone
(317) 899-3106
Fax
(317) 899-3141
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 12011004 IN Primary

Addresses

Primary practice location

986 N Mitthoeffer Rd
Indianapolis, IN 46229-2622

Mailing address

986 N Mitthoeffer Rd
Indianapolis, IN 46229-2622
Phone (317) 899-3106

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
I20170119002633 IN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1456633874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011004INMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of Indiana, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932303443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 N MITTHOEFFER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292622",
            "telephone_number": "317-899-3106",
            "fax_number": "317-899-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 N MITTHOEFFER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292622",
            "telephone_number": "317-899-3106",
            "fax_number": "317-899-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.