Individual provider Active NPI

John Edward Hoover, D.D.S.

  • General Practice Dentistry
  • Azle, TX
National Provider Identifier
1164822896
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30110 Issued in TX
Practice address
405 Inwood Rd
Azle, TX 76020-4825
Phone
(940) 210-1016
Fax
(817) 444-9685
NPI assigned
Aug 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 30110 TX Primary

Addresses

Primary practice location

405 Inwood Rd
Azle, TX 76020-4825

Mailing address

405 Inwood Rd
Azle, TX 76020-4825
Phone (817) 444-6955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161025001611 TX Order and Referring Only - DentistPractitioner - Dentist 2365733375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30110TXMDGeneral Practice Dentistry
6658OKMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1164822896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 INWOOD RD",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760204825",
            "telephone_number": "817-444-6955",
            "fax_number": "817-444-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 INWOOD RD",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760204825",
            "telephone_number": "940-210-1016",
            "fax_number": "817-444-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azle, TX

Sources for this page

Verify at the official NPI Registry.