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NPI Code Detail

MEDICARE: JACK MEHLING

MEDICARE: JACK MEHLING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12015029AIN

General Provider Information

NPI Number : 1588597348
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK MEHLING
Provider Business Mailing Address
First Line : 1855 STAFFORD RD
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2338
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1855 STAFFORD RD
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2338
Country : US
Telephone Number : 317-839-2088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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