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JIE LI DDS
NPI 1609457100
Dentist in Fort Wayne, IN

Active since April 16, 2021PECOS Enrolled
1717 S CALHOUN ST, FORT WAYNE, IN 46802(260) 458-2641 Get Directions Write a Review

NPPES record last updated: April 16, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jie Li Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIE LI DDS (NPI 1609457100) is an individual dentist in Fort Wayne, Indiana, licensed in Indiana (13006783A) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609457100
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameJIE LICredential: DDS
Location Address1717 S CALHOUN STFort Wayne, IN 46802-5257
Mailing Address6903 Vistamere WayIndianapolis, IN 46250-4156 · (317) 750-3981
Phone(260) 458-2641
Sole ProprietorNo
Enumeration DateApril 16, 2021
NPPES CertifiedApril 16, 2021
✔ NPI 1609457100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IN · 13006783A
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1717 S CALHOUN ST, Fort Wayne, IN 46802
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Other Identifiers 1

Other13006783AIN · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jie Li Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RONALD R HALL M.D.
Pediatrics
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
LINDSEY DIANE HOSKINS
Physician Assistant
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2541
ALLISON TRELEAVEN O.D.
Optometrist
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
ZELALEM BOGALE AMARE
Dentist (General Practice)
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
MS. LUDMILA ROEBEL NURSE PRACTITIONER
Nurse Practitioner (Women's Health)
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
DR. MIRIVA MAGAR M.D.
Pediatrics
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
TESSA CREAGER
Dentist
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641
DR. ANGELA R OJEDA DDS
Dentist (General Practice)
1717 S CALHOUN ST
FORT WAYNE, IN 46802
Allen County (260) 458-2641

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jie Li's NPI number?

The NPI number for Jie Li is 1609457100. It was assigned to this individual provider in the NPPES registry on April 16, 2021.

Where is Jie Li located?

Jie Li practices at 1717 S Calhoun St, Fort Wayne, IN 46802. The listed phone number is (260) 458-2641.

What is Jie Li's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jie Li enrolled in Medicare?

Yes. Jie Li is registered in the Medicare PECOS enrollment system.

What insurance does Jie Li accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, BEST Life and Blue Cross and Blue Shield of Montana and 12 other insurers list Jie Li as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jie Li was last updated on April 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.