Organization Active NPI

Paradox DSM LLC

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1316769995
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PARADOX DSM LLC
Practice address
4950 E Stop 11 Rd
Indianapolis, IN 46237-9100
Phone
(317) 865-1300
NPI assigned
Oct 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Carole Eleise Thoman, DDSNPI 1487775144
Title
DDS
Phone
(317) 865-1300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4950 E Stop 11 Rd
Indianapolis, IN 46237-9100

Mailing address

32 N Main St
Indianapolis, IN 46227-5136
Phone (317) 443-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250625002099 IN DME Supplier - Oral Surgery - Dentist 4284146291 Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

4950 E Stop 11 Rd
Indianapolis, IN 46237
Phone (317) 859-5857

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1316769995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 N MAIN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462275136",
            "telephone_number": "317-443-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 E STOP 11 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379100",
            "telephone_number": "317-865-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADOX DSM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "THOMAN",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "ELEISE",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "317-865-1300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.