Individual provider Active NPI

Mitchell Vanhoose

  • Dentist
  • Zanesville, OH
National Provider Identifier
1083094569
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30024515 Issued in OH
Practice address
716 Adair Ave
Zanesville, OH 43701-2836
Phone
(740) 891-9000
Fax
(740) 891-9001
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30024515 OH Primary

Addresses

Primary practice location

716 Adair Ave
Zanesville, OH 43701-2836

Mailing address

859 N Main St
Malta, OH 43758-9007
Phone (740) 962-6111

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201002088 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012217847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30024515OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1083094569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 N MAIN ST",
            "city": "MALTA",
            "state": "OH",
            "postal_code": "437589007",
            "telephone_number": "740-962-6111",
            "fax_number": "740-962-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 ADAIR AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012836",
            "telephone_number": "740-891-9000",
            "fax_number": "740-891-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHOOSE",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30024515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.