Active NPI
Michael R Ranjbar, PHD, DDS
- Dentist
- Brownsburg, IN
National Provider Identifier
1992869564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12010595A
- Practice address
- 475 E Northfield Dr Ste E
Brownsburg, IN 46112-2210 - Phone
- (317) 852-8174
- Fax
- (317) 852-9005
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12010595A | IN | Primary |
Addresses
Primary practice location
475 E Northfield Dr Ste E
Brownsburg, IN 46112-2210
Mailing address
475 E Northfield Dr Ste E
Brownsburg, IN 46112-2210
Phone (317) 852-8174
Other practice location 1
19 Motif Blvd
Brownsburg, IN 46112-1017
Phone (317) 852-8174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200462160A | Medicaid | IN |
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 |
|---|---|---|---|---|
| I20150610002068 | IN | Order and Referring Only - Oral Surgery | 2668793035 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1992869564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 E NORTHFIELD DR STE E",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461122210",
"telephone_number": "317-852-8174",
"fax_number": "317-852-9005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 E NORTHFIELD DR STE E",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461122210",
"telephone_number": "317-852-8174",
"fax_number": "317-852-9005"
}
],
"practiceLocations": [
{
"address_1": "19 Motif Blvd",
"address_purpose": "LOCATION",
"city": "Brownsburg",
"state": "IN",
"postal_code": "461121017",
"country_code": "US",
"telephone_number": "317-852-8174",
"fax_number": "317-852-9005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RANJBAR",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "PHD, DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12010595A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200462160A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.