Individual provider Active NPI

David E. Heisel, DDS

  • Dentist
  • Columbus, OH
National Provider Identifier
1144302712
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.014950 Issued in OH
Practice address
240 Parsons Ave
Columbus, OH 43215-5331
Phone
(614) 645-7417
NPI assigned
Oct 20, 2006
Last updated
Jul 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.014950 OH Primary

Addresses

Primary practice location

240 Parsons Ave
Columbus, OH 43215-5331

Mailing address

240 Parsons Ave
Columbus, OH 43215-5331
Phone (614) 645-7417

Other identifiers 3

IdentifierTypeStateIssuer
316400223035OtherOHCARESOURCE GROUP #
0616622MedicaidOH
0436291MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.014950OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1144302712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PARSONS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155331",
            "telephone_number": "614-645-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PARSONS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155331",
            "telephone_number": "614-645-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISEL",
        "first_name": "DAVID",
        "middle_name": "E.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.014950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE GROUP #",
            "identifier": "316400223035",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0616622",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0436291",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.