Active NPI
William Michael Princell, DDS
- General Practice Dentistry
- Indianapolis, IN
National Provider Identifier
1184820813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12009143
- Practice address
- 7207 N Shadeland Ave
Suite a
Indianapolis, IN 46250-2880 - Phone
- (317) 577-2478
- NPI assigned
- Jun 21, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12009143 | IN | Primary |
Addresses
Primary practice location
7207 N Shadeland Ave
Suite a
Indianapolis, IN 46250-2880
Mailing address
10252 Springstone Rd
MC Cordsville, IN 46055-9632
Phone (317) 335-3711
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 |
|---|---|---|---|---|
| I20150608001809 | IN | Order and Referring Only - Oral Surgery | 5193046761 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009143 | IN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184820813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10252 SPRINGSTONE RD",
"city": "MC CORDSVILLE",
"state": "IN",
"postal_code": "460559632",
"telephone_number": "317-335-3711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7207 N SHADELAND AVE",
"address_2": "SUITE A",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502880",
"telephone_number": "317-577-2478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINCELL",
"first_name": "WILLIAM",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12009143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
- Primus Health
- Ruben Prince-Cooper, BS
- Tammi Latonya Prince-Cooper, LMHC, LCAC, CSAYC
- McKenzie Renee Prince, BCBA
- Melvin Jay Prince, M.D.
- Princessizzy LLC (Serenity Care Services)
- Principle Health Solutions, LLC
- Principled Homecare LLC
- Prings Dialysis LLC (Eagle Highlands Dialysis)
- Austin Prior, BCBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.