Individual provider Active NPI

Dayton W Dawson, DDS

  • Dentist
  • Danville, IN
National Provider Identifier
1992991152
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011067A Issued in IN
Practice address
1669 E Main St
Danville, IN 46122-9468
Phone
(317) 745-5173
Fax
(317) 745-5023
NPI assigned
Sep 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011067A IN Primary

Addresses

Primary practice location

1669 E Main St
Danville, IN 46122-9468

Mailing address

1669 E Main St
Danville, IN 46122-9468
Phone (317) 745-5173

Other identifiers 1

IdentifierTypeStateIssuer
100133020MedicaidIN

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
I20111215000373 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476728775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dawson Family Dentistry Dentist PastSince Jan 15, 2010 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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1992991152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461229468",
            "telephone_number": "317-745-5173",
            "fax_number": "317-745-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461229468",
            "telephone_number": "317-745-5173",
            "fax_number": "317-745-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "DAYTON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011067A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100133020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IN

Sources for this page

Verify at the official NPI Registry.