Daniel Mensah-Boateng, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011454A Issued in IN

Practice address

812 Lawrence Dr
Fort Wayne, IN 46804-1192

Phone

(260) 387-5890

Fax

(260) 444-3149

NPI assigned

Jul 20, 2010

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

Other identifiers 1

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

Practice roles

Locations

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.

• Gentle Care Family Dentistry

  • Dentist
  • Fort Wayne, IN
  • NPI 1467726851
  NPD Authorized official

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1962715904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 LAWRENCE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041192",
            "telephone_number": "260-387-5890",
            "fax_number": "260-444-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 LAWRENCE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041192",
            "telephone_number": "260-387-5890",
            "fax_number": "260-444-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSAH-BOATENG",
        "first_name": "DANIEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011454A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200988310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emiliano Mendoza, PT
• Erick Mendoza, PA-C
• Gil F Mendoza, MD
• Linda K Menke, LCSW MSW
• Mohan M Menon, M.D.
• Christine Mensah, RBT
• Miles Benjamin Menuck, DO
• Anna Menze-Wagner, DO
• Shandi Menzie
• Anya V Menzies, M.D.

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.