Individual provider Active NPI

Jennifer Rose Van Hook, DMD

  • Student in an Organized Health Care Education/Training Program
  • West Columbia, SC
National Provider Identifier
1053971861
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0401416503 Issued in VA
Practice address
3573 Sunset Blvd
West Columbia, SC 29169-3043
Phone
(803) 973-4530
Fax
(803) 973-4533
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401416503 VA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DGD.10440 SC
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 0401416503 VA
Student in an Organized Health Care Education/Training Program 390200000X 0401416503 VA Primary

Addresses

Primary practice location

3573 Sunset Blvd
West Columbia, SC 29169-3043

Mailing address

3573 Sunset Blvd
West Columbia, SC 29169-3043
Phone (803) 973-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Sep 29, 2023 through Sep 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DGD.10440SCMDOral and Maxillofacial Surgery (Dentist)
10585SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho Oral and Maxillofacial Surgery PastSince Jul 2, 2023 Accepting new patients
DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho Oral & Maxillofacial Surgery PastSince Jul 2, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1053971861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3573 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693043",
            "telephone_number": "803-973-4530",
            "fax_number": "803-973-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3573 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693043",
            "telephone_number": "803-973-4530",
            "fax_number": "803-973-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HOOK",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2023-08-22",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401416503",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "DGD.10440",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0401416503",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0401416503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.