Individual provider Active NPI

Charles Foulke Hine, D.D.S.

  • Endodontics
  • Indianapolis, IN
National Provider Identifier
1083773303
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12010356A Issued in IN
Practice address
5701 Autumn Breeze CT
Indianapolis, IN 46237-9412
Phone
(317) 213-8478
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 12010356A IN Primary

Addresses

Primary practice location

5701 Autumn Breeze CT
Indianapolis, IN 46237-9412

Mailing address

5701 Autumn Breeze CT
Indianapolis, IN 46237-9412

Other practice location 1

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

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
I20150324000999 IN Order and Referring Only - DentistPractitioner - Dentist 5395062798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12010356AINMDEndodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1083773303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 AUTUMN BREEZE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 AUTUMN BREEZE CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379412",
            "telephone_number": "317-213-8478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINE",
        "first_name": "CHARLES",
        "middle_name": "FOULKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12010356A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.