Active NPI
John Dee Dickerson, DDS
- General Practice Dentistry
- Columbus, OH
National Provider Identifier
1023360617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12660
- Practice address
- 2060 Arlington Ave
Columbus, OH 43221-4312 - Phone
- (614) 486-7782
- NPI assigned
- Oct 8, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 12660 | OH | Primary |
Addresses
Primary practice location
2060 Arlington Ave
Columbus, OH 43221-4312
Mailing address
2060 Arlington Ave
Columbus, OH 43221-4312
Phone (614) 486-7782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12660 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349654400000",
"number": "1023360617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2060 ARLINGTON AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432214312",
"telephone_number": "614-486-7782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2060 ARLINGTON AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432214312",
"telephone_number": "614-486-7782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "JOHN",
"middle_name": "DEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-08",
"last_updated": "2012-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "12660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.