Active NPI
Paul Louis Wolf, D.D.S.
- Oral & Maxillofacial Surgery (D.M.D.)
- Schererville, IN
National Provider Identifier
1346221108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 12010083
- Practice address
- 601 W US Highway 30
Schererville, IN 46375-2656 - Phone
- (219) 322-0501
- Fax
- (219) 322-0577
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 12010083A | IN | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 12010083 | IN | Primary |
Addresses
Primary practice location
601 W US Highway 30
Schererville, IN 46375-2656
Mailing address
601 W US Highway 30
Schererville, IN 46375-2656
Phone (219) 322-0501
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00111143 | Other | IN | RAILROAD MEDICARE NUMBER |
| 000000084422 | Other | IN | BC BS PROVIDER PIN NUMBER |
| 200196800 | Medicaid | IN | |
| 986521 | Other | IN | UNITED CONCORDIA NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010083 | IN | MD | Oral & Maxillofacial Surgery (D.M.D.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1346221108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W US HIGHWAY 30",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463752656",
"telephone_number": "219-322-0501",
"fax_number": "219-322-0577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W US HIGHWAY 30",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463752656",
"telephone_number": "219-322-0501",
"fax_number": "219-322-0577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "PAUL",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IN",
"license": "12010083A",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "IN",
"license": "12010083",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "P00111143",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS PROVIDER PIN NUMBER",
"identifier": "000000084422",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200196800",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA NUMBER",
"identifier": "986521",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Schererville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.