MEDICARE: DR. CHARLES FOULKE HINE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	12010356A	IN

General Provider Information

NPI Number	:	1083773303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES FOULKE HINE D.D.S.

Provider Business Mailing Address
First Line	:	5701 AUTUMN BREEZE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9412
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 AUTUMN BREEZE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9412
Country	:	US
Telephone Number	:	317-213-8478
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	05/27/2026

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