Individual provider Active NPI

Marycarmen Carpio Hernandez

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1235741083
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12013447A Issued in IN
Practice address
3636 E 38TH St
Indianapolis, IN 46218-1454
Phone
(317) 743-0300
NPI assigned
Aug 21, 2020
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013447A IN Primary

Addresses

Primary practice location

3636 E 38TH St
Indianapolis, IN 46218-1454

Mailing address

1967 N County Road 100 E
Danville, IN 46122-8309
Phone (317) 946-0703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12013447AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1235741083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 N COUNTY ROAD 100 E",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461228309",
            "telephone_number": "317-946-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 E 38TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462181454",
            "telephone_number": "317-743-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPIO HERNANDEZ",
        "first_name": "MARYCARMEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013447A",
            "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 Aug 21, 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.