Active NPI
Frederick David Hogan, DDS
- General Practice Dentistry
- Hamilton, OH
National Provider Identifier
1003900580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 17933
- Practice address
- 2428 Pleasant Ave
Hamilton, OH 45015 - Phone
- (513) 868-9100
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 17933 | OH | Primary |
Addresses
Primary practice location
2428 Pleasant Ave
Hamilton, OH 45015
Mailing address
7590 N Gilmore Rd
Hamilton, OH 45015
Phone (513) 737-7007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161031001683 | OH | Order and Referring Only - Dentist | 2567740202 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17933 | OH | MD | General Practice Dentistry |
Networks
- KY PPO C-SNP
- devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
- devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
- devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1003900580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7590 N GILMORE RD",
"city": "HAMILTON",
"state": "OH",
"postal_code": "45015",
"telephone_number": "513-737-7007",
"fax_number": "513-868-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2428 PLEASANT AVE",
"city": "HAMILTON",
"state": "OH",
"postal_code": "45015",
"telephone_number": "513-868-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGAN",
"first_name": "FREDERICK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "17933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.