Michael Douglas Edwards, DDS,MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12010349A Issued in IN

Practice address

8801 N Meridian St
Suite 103
Indianapolis, IN 46260-2396

Phone

(317) 574-0600

Fax

(317) 574-0606

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Meridian Street Periodontics, LLC

  • Periodontics
  • Indianapolis, IN
  • NPI 1518470897
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255420600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 N MERIDIAN ST",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602396",
            "telephone_number": "317-574-0600",
            "fax_number": "317-574-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 N MERIDIAN ST",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602396",
            "telephone_number": "317-574-0600",
            "fax_number": "317-574-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12010349A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Elizabeth Edwards
• Mara Edwards, WRAPAROUND
• Mark A Edwards, M.D.
• Mark L Edwards, MD
• Mia Edwards
• Natalee Renee Edwards, PA-C
• Paul C. Edwards, DDS
• Peggy Lynn Edwards, ACSW, LCSW
• Ryleigh Rene Edwards, PA-C
• Shanika Edwards

• Periodontics in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Periodontics in Indiana

• 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.

Verify at the official NPI Registry.