Active NPI
Ajay Joshi, DDS
- General Practice Dentistry
- Fort Wayne, IN
National Provider Identifier
1952497166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12010878A
- Practice address
- 1852 Bluffton Rd
Fort Wayne, IN 46809-1306 - Phone
- (260) 479-1086
- Fax
- (260) 478-4621
- NPI assigned
- Oct 5, 2006
- 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 | 12010878A | IN | Primary |
Addresses
Primary practice location
1852 Bluffton Rd
Fort Wayne, IN 46809-1306
Mailing address
12989 Rocky Pointe Rd
MC Cordsville, IN 46055-9584
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170113000117 | IN | Order and Referring Only - Oral Surgery | 9830471580 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010878A | IN | MD | General Practice Dentistry |
| 12010787A | IN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kool Smiles in Ft. Wayne, 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Ft. Wayne, IN
- NPI 1679660278
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952497166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12989 ROCKY POINTE RD",
"city": "MC CORDSVILLE",
"state": "IN",
"postal_code": "460559584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1852 BLUFFTON RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091306",
"telephone_number": "260-479-1086",
"fax_number": "260-478-4621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSHI",
"first_name": "AJAY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12010878A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.