Individual provider Active NPI

William Chung, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
National Provider Identifier
1295716322
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12013940A Issued in IN
Practice address
1121 W Michigan St
Indianapolis, IN 46202-5211
Phone
(317) 274-7433
Fax
(317) 274-2603
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12013940A IN Primary

Addresses

Primary practice location

1121 W Michigan St
Indianapolis, IN 46202-5211

Mailing address

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

Other practice location 1

550 University Blvd Ste 3145
Indianapolis, IN 46202-5149
Phone (317) 274-5315

Other identifiers 1

IdentifierTypeStateIssuer
1947519MedicaidPA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025000426 IN Practitioner - Maxillofacial SurgeryPractitioner - DentistPractitioner - Anesthesiology 1254528474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Anesthesiology, Dentist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana UniversityGroup PAC ID 6002806957, 64 clinicians

Practice addresses (Care Compare)

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 274-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Oral and Maxillofacial Surgery CurrentSince Oct 4, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

550 University Blvd
Ste 3195
Indianapolis, IN 46202
Phone (317) 274-7433

1121 W Michigan St
#307B
Indianapolis, IN 46202
Phone (317) 274-7433

550 University Blvd
Ste 3145
Indianapolis, IN 46202
Phone (317) 274-5315

1121 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-7433

550 University Blvd
#3195
Indianapolis, IN 46202
Phone (317) 274-6300

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1295716322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7433",
            "fax_number": "317-274-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7433",
            "fax_number": "317-274-2603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Ste 3145",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-274-5315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12013940A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1947519",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.