DR. JASON D DEDOES DPM NPI 1851536023

NPI Information

NPI: 1851536023
Provider Name: DR. JASON D DEDOES, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
213 FAIRVIEW BLVD
KENDALLVILLE, IN
ZIP 46755
Phone: (260) 347-2833
Get Directions

DR. Jason D Dedoes, DPM is a foot and ankle surgery podiatrist in Kendallville, IN with 17 years of experience. DR. Jason D Dedoes, DPM NPI is 1851536023. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:2007

The provider's business location address is:

213 FAIRVIEW BLVD
KENDALLVILLE, IN
ZIP 46755-988
Phone: (260) 347-2833
Fax: (260) 668-7563

The NPI 1851536023 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/2/2008 and was last updated on 10/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	T13-2008	TEXAS	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	07001105A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201002160	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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