DR. WILLIAM EDWARD PAUL DDS
NPI 1346289857
Dentist - Oral and Maxillofacial Surgery in South Bend, IN
NPI Status: Active since June 06, 2006
Contact Information
926 EAST LASALLE AVENUE
SOUTH BEND, IN
ZIP 46617
Phone: (574) 233-7700
Fax: (574) 233-8264
- Individual
- Male
- Years of Experience 50
- Dentist
- Oral and Maxillofacial Surgery
- Accepts Insurance
- May Accept Medicare Approved Payment
- Opted-Out Medicare
About WILLIAM PAUL
This page provides the complete NPI Profile along with additional information for William Paul, a provider established in South Bend, Indiana with a medical specialization in Dentist, focusing in oral and maxillofacial surgery and more than 50 years of experience. He graduated from Indiana University School Of Dentistry in 1976. The healthcare provider is registered in the NPI registry with number 1346289857 assigned on June 2006. The practitioner's primary taxonomy code is 1223S0112X with license number 12007373A (IN). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1346289857
- Provider Name
- DR. WILLIAM EDWARD PAUL DDS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 926 EAST LASALLE AVENUE SOUTH BEND, IN 46617
- Location Phone
- (574) 233-7700
- Location Fax
- (574) 233-8264
- Mailing Address
- 926 EAST LASALLE AVENUE SOUTH BEND, IN 46617
- Mailing Phone
- (574) 233-7700
- Mailing Fax
- (574) 233-8264
- Medical School Name
- INDIANA UNIVERSITY SCHOOL OF DENTISTRY
- Graduation Year
- 1976
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-06-2006
- Last Update Date
- 12-13-2016
- Code Navigator
A dentist like William Paul is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. William Paul opted out of Medicare effective on 04-17-2023 until 04-17-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 12007373A
- License State
- IN
- Taxonomy Description
- An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 9200 (+ Incentives) - HMO
- Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 9200 (+ Incentives) - EPO
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Bronze Standard - HMO
- Catastrophic Standard - HMO
- Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Gold Standard - HMO
- Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
- Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
- Silver Standard - HMO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Delta Dental Individual Pediatric-Only PPO, EHB Certified - PPO
- Delta Dental Individual PPO Bronze Plan, EHB Certified - PPO
- Delta Dental Individual PPO Gold Plan, EHB Certified - PPO
- Delta Dental Individual PPO Silver Plan, EHB Certified - PPO
- Guardian Basics for Families and Individuals - PPO
- Guardian Essentials for Families and Individuals - PPO
- Guardian Preventive Plus for Families and Individuals - PPO
- Guardian Select for Families and Individuals - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
- Paramount Dental Essential Plus Plan - EPO
- Paramount Dental Preventive Family Plan - EPO
- Paramount Dental Total Care Plan - EPO
- HRI Essential Plus Plan - HMO
- HRI Essential Plus Plan - PPO
- HRI Preventive Family Plan - HMO
- HRI Preventive Family Plan - PPO
- HRI Total Care Plan - HMO
- HRI Total Care Plan - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| U28562 | MEDICARE UPIN (02) | ||
| 736780 | MEDICARE ID-TYPE UNSPECIFIED (04) | IN | |
| 100222380A | MEDICAID (05) | IN |
Medicare Participation & PECOS Enrollment Status
William Paul is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-17-2023
Opt-Out End Date: 04-17-2025
Eligible to Order and Refer? No
PECOS PAC ID: 3274713367
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20110207000535
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Reviews for DR. WILLIAM EDWARD PAUL DDS
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 4 | 6 | 2 | 8 | 9 | 8 | 5 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 8 | 6 | 4 | 8 | 18 | 8 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 8 + 6 + 4 + 8 + 1 + 8 + 8 + 1 + 0 + 24 = 73 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 73 = 7 | 7 | ||||||||
The NPI number 1346289857 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1285662163 | WILLIAM E PAUL DDS PC Organization | Oral & Maxillofacial Surgery | 926 EAST LASALLE AVENUE SOUTH BEND, IN 46617 (574) 233-7700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1346289857, enumerated in the NPI registry as an "individual" on June 06, 2006
The provider is located at 926 East Lasalle Avenue South Bend, In 46617 and the phone number is (574) 233-7700
The provider's speciality is Dentist with taxonomy code 1223S0112X with a focus in Oral and Maxillofacial Surgery
The provider has more than 50 years of experience. He graduated from Indiana University School Of Dentistry in 1976.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Meridian, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on April 17, 2023 to opt-out of the Medicare program. The provider is excluded from the Medicare program until April 17, 2025.
This NPI record was last updated on June 06, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.