Individual provider Active NPI

Eric Robert Hotze, DMD

  • General Practice Dentistry
  • Hazelwood, MO
National Provider Identifier
1174638746
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
014198 Issued in MO
Practice address
6312 Hazelwest CT
Suite #100
Hazelwood, MO 63042
Phone
(314) 731-1200
Fax
(314) 731-2630
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

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 014198 MO Primary

Addresses

Primary practice location

6312 Hazelwest CT
Suite #100
Hazelwood, MO 63042

Mailing address

6312 Hazelwest CT
Suite #100
Hazelwood, MO 63042
Phone (314) 731-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20151119002253 MO Order and Referring Only - DentistPractitioner - Dentist 1850691080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014198MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eric R Hotze, DMD, PC 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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174638746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 HAZELWEST CT",
            "address_2": "SUITE #100",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "63042",
            "telephone_number": "314-731-1200",
            "fax_number": "314-731-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 HAZELWEST CT",
            "address_2": "SUITE #100",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "63042",
            "telephone_number": "314-731-1200",
            "fax_number": "314-731-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTZE",
        "first_name": "ERIC",
        "middle_name": "ROBERT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazelwood, MO

Sources for this page

Verify at the official NPI Registry.