NPIMap

Organization Active NPI

Carmel Dental Care, PC

  • General Practice Dentistry
  • Carmel, IN
National Provider Identifier
1124121793
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54001033A Issued in IN
Legal business name
CARMEL DENTAL CARE, PC
Practice address
1980 E 116TH St
Suite 150
Carmel, IN 46032-3599
Phone
(317) 848-1771
Fax
(317) 848-1371
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandra Bacon, DDSNPI 1164539318
Title
Owner
Phone
(317) 848-1771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 54001033A IN Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12009028 IN

Addresses

Primary practice location

1980 E 116TH St
Suite 150
Carmel, IN 46032-3599

Mailing address

1980 E 116TH St
Suite 150
Carmel, IN 46032-3599
Phone (317) 848-1771

National Provider Directory

National Provider Directory

Locations

1980 E 116th St
Ste 150
Carmel, IN 46032
Phone (317) 848-1771

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124121793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 E 116TH ST",
            "address_2": "SUITE 150",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323599",
            "telephone_number": "317-848-1771",
            "fax_number": "317-848-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 E 116TH ST",
            "address_2": "SUITE 150",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323599",
            "telephone_number": "317-848-1771",
            "fax_number": "317-848-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMEL DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-848-1771",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "54001033A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.