Individual provider Active NPI

David W Hancock, D.D.S.

  • General Practice Dentistry
  • Lima, OH
National Provider Identifier
1154486850
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-020842 Issued in OH
Practice address
555 W Elm St
Lima, OH 45801-4757
Phone
(419) 229-0776
Fax
(419) 229-3828
NPI assigned
Dec 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 30-020842 OH Primary

Addresses

Primary practice location

555 W Elm St
Lima, OH 45801-4757

Mailing address

555 W Elm St
Lima, OH 45801-4757
Phone (419) 229-0776

Other identifiers 1

IdentifierTypeStateIssuer
2081376MedicaidOH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30-020842OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
555 W Elm St Dentistry LLC 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": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154486850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W ELM ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014757",
            "telephone_number": "419-229-0776",
            "fax_number": "419-229-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W ELM ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014757",
            "telephone_number": "419-229-0776",
            "fax_number": "419-229-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-020842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2081376",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.