Individual provider Active NPI

Christopher Jeremy Maddox, DDS

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1134344807
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30020431 Issued in OH
Practice address
5630 Bridgetown Rd
Cincinnati, OH 45248-4346
Phone
(513) 574-7511
Fax
(513) 574-8713
NPI assigned
Apr 16, 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 30020431 OH Primary

Addresses

Primary practice location

5630 Bridgetown Rd
Cincinnati, OH 45248-4346

Mailing address

5630 Bridgetown Rd
Cincinnati, OH 45248-4346
Phone (513) 574-7511

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
I20161202002206 OH Order and Referring Only - DentistPractitioner - Dentist 9537449871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30020431OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher J Maddox DDS Inc General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134344807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 BRIDGETOWN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452484346",
            "telephone_number": "513-574-7511",
            "fax_number": "513-574-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 BRIDGETOWN RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452484346",
            "telephone_number": "513-574-7511",
            "fax_number": "513-574-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "CHRISTOPHER",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30020431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.