Paul C. Edwards, DDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

12012036A Issued in IN

Practice address

1121 W Michigan Street
Indianapolis, IN 46202-5186

Phone

(317) 274-5628

Fax

(317) 274-2603

NPI assigned

Aug 29, 2005

Last updated

Oct 31, 2013By 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 3

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

Specialty

Oral Surgery

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana UniversityGroup PAC ID 6002806957, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Indiana University

  dba Indiana University School of Dentistry

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552
  Medicare reassignment Care Compare group
• University Dental Service Plan Inc

  dba Dental Faculty Private Practice

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1407996291
  NPD
• Regents of the University of Michigan Dental Faculty Associates

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1932279882
  NPD (past)
• Regents of the University of Michigan Oral Pathology

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
  • NPI 1083739262
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1356334072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "317-274-5628",
            "fax_number": "317-274-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "317-274-5628",
            "fax_number": "317-274-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "PAUL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NE",
            "license": "106",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019526",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IN",
            "license": "12012036A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark A Edwards, M.D.
• Mark L Edwards, MD
• Mia Edwards
• Michael Douglas Edwards, DDS,MSD
• Natalee Renee Edwards, PA-C
• Peggy Lynn Edwards, ACSW, LCSW
• Ryleigh Rene Edwards, PA-C
• Shanika Edwards
• Shawna Renee Edwards, FNP
• Steven Michael Edwards, R.PH.

• Oral and Maxillofacial Pathology Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Pathology Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.