Individual provider Active NPI

Edward G Garry, DMD

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1255537353
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009233A Issued in IN
Practice address
7015 US 31 Ste C
Indianapolis, IN 46227-8619
Phone
(463) 276-0541
Fax
(463) 276-0542
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009233A IN Primary

Addresses

Primary practice location

7015 US 31 Ste C
Indianapolis, IN 46227-8619

Mailing address

7015 US 31 Ste C
Indianapolis, IN 46227-8619
Phone (463) 276-0541

Other identifiers 1

IdentifierTypeStateIssuer
100193970AMedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161107002088 IN Order and Referring Only - DentistPractitioner - Dentist 5698054096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009233AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Emergency Dental Bloomington LLC General Practice Current Accepting new patients
Indiana Emergency Dental Fishers LLC General Practice CurrentSince Apr 27, 2025 Accepting new patients
Indiana Emergency Dental General Practice CurrentSince Oct 8, 2023 Accepting new patients
Indiana Emergency Dental Terre Haute LLC General Practice Current Accepting new patients
Joshua Stoner DDS LLC PastSince Nov 21, 2021 Accepting new patients

Locations

7015 US 31
Ste C
Indianapolis, IN 46227
Phone (463) 276-0541

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1255537353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 US 31 STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278619",
            "telephone_number": "463-276-0541",
            "fax_number": "463-276-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 US 31 STE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462278619",
            "telephone_number": "463-276-0541",
            "fax_number": "463-276-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRY",
        "first_name": "EDWARD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009233A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100193970A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.