Individual provider Active NPI

Lawrence A Pauley, DDS

  • General Practice Dentistry
  • Carmel, IN
National Provider Identifier
1376557934
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10369 Issued in IN
Practice address
624 S Range Line Rd
Carmel, IN 46032-2188
Phone
(317) 848-1810
Fax
(317) 815-4660
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10369 IN Primary

Addresses

Primary practice location

624 S Range Line Rd
Carmel, IN 46032-2188

Mailing address

624 S Range Line Rd
Carmel, IN 46032-2188
Phone (317) 848-1810

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317002589 IN Order and Referring Only - DentistPractitioner - Dentist 6204153919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10369INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376557934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S RANGE LINE RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322188",
            "telephone_number": "317-848-1810",
            "fax_number": "317-815-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S RANGE LINE RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460322188",
            "telephone_number": "317-848-1810",
            "fax_number": "317-815-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULEY",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "10369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.