Active NPI
Charles Foulke Hine, D.D.S.
- Endodontics
- Indianapolis, IN
National Provider Identifier
1083773303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 12010356A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150324000999 | IN | Order and Referring Only - Dentist | 5395062798 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010356A | IN | MD | Endodontist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.