Individual provider Active NPI

Scott R Lopshire, D.D.S.

  • Dentist
  • Moline, IL
National Provider Identifier
1003088774
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
609 22ND St
Moline, IL 61265-1450
Phone
(309) 797-2001
Fax
(309) 764-8236
NPI assigned
Apr 2, 2008
Last updated
Apr 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

609 22ND St
Moline, IL 61265-1450

Mailing address

609 22ND St
Moline, IL 61265-1450
Phone (309) 797-2001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160708000664 IA Order and Referring Only - DentistPractitioner - Dentist 3678865862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.026517ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Dentistry, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1003088774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 22ND ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651450",
            "telephone_number": "309-797-2001",
            "fax_number": "309-764-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 22ND ST",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651450",
            "telephone_number": "309-797-2001",
            "fax_number": "309-764-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPSHIRE",
        "first_name": "SCOTT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.