Individual provider Active NPI

Philip L. Pike, D.D.S.

  • General Practice Dentistry
  • Wilmington, DE
National Provider Identifier
1104970730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
G1-0000937 Issued in DE
Practice address
4901 Limestone Rd
Wilmington, DE 19808-1271
Phone
(302) 239-0303
Fax
(302) 239-6755
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X G1-0000937 DE Primary

Addresses

Primary practice location

4901 Limestone Rd
Wilmington, DE 19808-1271

Mailing address

4901 Limestone Rd
Wilmington, DE 19808-1271
Phone (302) 239-0303

Other identifiers 1

IdentifierTypeStateIssuer
0000917108MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20160429000974 DE Order and Referring Only - DentistPractitioner - Dentist 5092014829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104970730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081271",
            "telephone_number": "302-239-0303",
            "fax_number": "302-239-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081271",
            "telephone_number": "302-239-0303",
            "fax_number": "302-239-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "PHILIP",
        "middle_name": "L.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "G1-0000937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000917108",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.