Individual provider Active NPI

Sharaschandra Reddy Govindool, BDS, MDS, MSC, PHD

  • Endodontics
  • Indianapolis, IN
National Provider Identifier
1649040619
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12014343B Issued in IN
Practice address
1121 W Michigan St
Indianapolis, IN 46202-5211
Phone
(571) 685-0161
Fax
(317) 274-7433
NPI assigned
Jan 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 12014343B IN Primary

Addresses

Primary practice location

1121 W Michigan St
Indianapolis, IN 46202-5211

Mailing address

1 Cambridge SQ Apt a
Williamsville, NY 14221-4822
Phone (571) 685-0161

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
I20240314002732 IN Order and Referring Only - DentistPractitioner - Dentist 6507202348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12014343BINMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1649040619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAMBRIDGE SQ APT A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214822",
            "telephone_number": "571-685-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "571-685-0161",
            "fax_number": "317-274-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVINDOOL",
        "first_name": "SHARASCHANDRA REDDY",
        "name_prefix": "Dr.",
        "credential": "BDS, MDS, MSC, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12014343B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.