Active NPI
Erik Mathew Snell, D.D.S.
- Dentist
- Liberty Township, OH
National Provider Identifier
1124464342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.023947
- Practice address
- 5307 Hildenbrand Way
Liberty Township, OH 45011 - Phone
- (513) 759-7635
- Fax
- (513) 755-2039
- NPI assigned
- May 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30.023947 | OH | Primary |
Addresses
Primary practice location
5307 Hildenbrand Way
Liberty Township, OH 45011
Mailing address
5307 Hildenbrand Way
Liberty Township, OH 45011
Phone (513) 759-7635
Other practice location 1
5307 Hildenbrand Way
Liberty Township, OH 45011
Phone (513) 759-7635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01014785 | Medicaid | OH |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150717001840 | OH | Order and Referring Only - Oral Surgery | 5193038255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Erik Snell Dentistry Evolved LLC | Current | Accepting new patients |
Locations
7570 Bales St
Ste 370
Liberty Township, OH 45069
5307 Hildenbrand Way
Liberty Twp, OH 45011
Phone (513) 759-7635
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Liberty Townshp, OH
- NPI 1649727876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1124464342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5307 HILDENBRAND WAY",
"city": "LIBERTY TOWNSHIP",
"state": "OH",
"postal_code": "45011",
"telephone_number": "513-759-7635",
"fax_number": "513-755-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5307 HILDENBRAND WAY",
"city": "LIBERTY TOWNSHIP",
"state": "OH",
"postal_code": "45011",
"telephone_number": "513-759-7635",
"fax_number": "513-755-2039"
}
],
"practiceLocations": [
{
"address_1": "5307 Hildenbrand Way",
"address_purpose": "LOCATION",
"city": "Liberty Township",
"state": "OH",
"postal_code": "45011",
"country_code": "US",
"telephone_number": "513-759-7635",
"fax_number": "513-755-2039",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SNELL",
"first_name": "ERIK",
"middle_name": "MATHEW",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2024-10-11",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.023947",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01014785",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liberty Township, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.