NPIMap

Organization Active NPI

BDD of Indiana P.C.

Doing business as McCarroll Dental

  • Dentist
  • Saint John, IN
National Provider Identifier
1538834064
Registry record updated Apr 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BDD OF INDIANA P.C.
Doing business as
McCarroll Dental
Ravenwood Dental
Practice address
10033 Wicker Ave Ste 9
Saint John, IN 46373-8777
Phone
(219) 365-9750
NPI assigned
Aug 16, 2021
Last updated
Apr 19, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BDD OF INDIANA P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2026

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

Authorized official

Name
Jay Jorbin
Title
Cfo
Phone
(312) 805-8590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

10033 Wicker Ave Ste 9
Saint John, IN 46373-8777

Mailing address

333 W 1St St
Elmhurst, IL 60126-2641

Other names 2

  • McCarroll Dental Doing business as
  • Ravenwood Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BDD of Indiana PC5 organizations share this tax ID, including this one
Part of
BDD of Indiana PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10033 Wicker Ave
Ste 9
Saint John, IN 46373
Phone (219) 365-9750

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776556800000",
    "number": "1538834064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W 1ST ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10033 WICKER AVE STE 9",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738777",
            "telephone_number": "219-365-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BDD OF INDIANA P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BDD OF INDIANA P.C.",
        "enumeration_date": "2021-08-16",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A",
        "authorized_official_last_name": "JORBIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-805-8590"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCarroll Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McCarroll Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ravenwood Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint John, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.