Active NPI
Richard M Loochtan, D.D.S., M.S., DDS MS
- Pediatric Dentistry
- Pickerington, OH
National Provider Identifier
1063479012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 18880
- Practice address
- 1600 Cross Creeks Blvd
Pickerington, OH 43147 - Phone
- (614) 863-8500
- Fax
- (614) 863-0874
- NPI assigned
- Apr 26, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 18880 | OH | Primary |
Addresses
Primary practice location
1600 Cross Creeks Blvd
Pickerington, OH 43147
Mailing address
1600 Cross Creeks Blvd
Pickerington, OH 43147
Phone (614) 863-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0819127 | Medicaid | OH |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18880 | OH | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264377600000",
"number": "1063479012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CROSS CREEKS BLVD",
"city": "PICKERINGTON",
"state": "OH",
"postal_code": "43147",
"telephone_number": "614-863-8500",
"fax_number": "614-863-0874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CROSS CREEKS BLVD",
"city": "PICKERINGTON",
"state": "OH",
"postal_code": "43147",
"telephone_number": "614-863-8500",
"fax_number": "614-863-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOOCHTAN, D.D.S., M.S.",
"first_name": "RICHARD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2010-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "18880",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0819127",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pickerington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.