Individual provider Active NPI

James M Oldham, DDS

  • General Practice Dentistry
  • Indianapolis, IN
National Provider Identifier
1992838312
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008511 Issued in IN
Practice address
1121 W Michigan St
Indianapolis, IN 46202-5211
Phone
(317) 278-3632
Fax
(317) 274-2603
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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 12008511 IN Primary

Addresses

Primary practice location

1121 W Michigan St
Indianapolis, IN 46202-5211

Mailing address

10449 Fall Creek Rd
Indianapolis, IN 46256-9517
Phone (317) 849-6505

Other identifiers 1

IdentifierTypeStateIssuer
100228080AMedicaidIN

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
I20160810001760 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2769776913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008511INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1992838312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10449 FALL CREEK RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462569517",
            "telephone_number": "317-849-6505",
            "fax_number": "317-274-1363"
        },
        {
            "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": "317-278-3632",
            "fax_number": "317-274-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100228080A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.