Tim Bacsa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010741A Issued in IN

Practice address

5895 E Thompson Rd
Indianapolis, IN 46237-2590

Phone

(317) 784-5555

Fax

(317) 333-7446

NPI assigned

Apr 16, 2007

Last updated

Nov 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1265657225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5895 E THOMPSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372590",
            "telephone_number": "317-784-5555",
            "fax_number": "317-333-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 E THOMPSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462372590",
            "telephone_number": "317-784-5555",
            "fax_number": "317-333-7446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4625 S Emerson Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462035972",
            "country_code": "US",
            "telephone_number": "317-784-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACSA",
        "first_name": "TIM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "19026831",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010741A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Scott Bacon, MD
• Gary Lee Bacon, D.D.S.
• Starr Bacon
• Veronica Bacon
• Bacsa Dental PC (Emerson Avenue Detnal)
• Brent Taylor Bacus
• Aashia M Bade, PSY.D., HSPP
• Emmaleigh Badeaux, MA
• Junot Badette
• Erin Badger

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.