Active NPI
Amenah Thneibat, DDS, MSD
- General Practice Dentistry
- Indianapolis, IN
National Provider Identifier
1982992590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12011625A
- Practice address
- 3838 N Rural St
Indianapolis, IN 46205-2930 - Phone
- (317) 221-5922
- NPI assigned
- Jul 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 12011625A | IN | Primary |
Addresses
Primary practice location
3838 N Rural St
Indianapolis, IN 46205-2930
Mailing address
3840 N Sherman Dr
Indianapolis, IN 46226-4462
Phone (317) 221-3013
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 |
|---|---|---|---|---|
| I20150513001522 | IN | Order and Referring Only - Dentist | 7315267440 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1982992590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3840 N SHERMAN DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462264462",
"telephone_number": "317-221-3013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3838 N RURAL ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052930",
"telephone_number": "317-221-5922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THNEIBAT",
"first_name": "AMENAH",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-17",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12011625A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.