Individual provider Active NPI

Jerad Lyle Hintz, D.D.S.

  • Dentist
  • Ankeny, IA
National Provider Identifier
1184887630
Registry record updated Jul 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08568 Issued in IA
Practice address
319 N Ankeny Blvd
Ankeny, IA 50023-1711
Phone
(515) 965-1653
NPI assigned
Jul 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 08568 IA Primary

Addresses

Primary practice location

319 N Ankeny Blvd
Ankeny, IA 50023-1711

Mailing address

319 N Ankeny Blvd
Ankeny, IA 50023-1711
Phone (515) 965-1653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20151221001165 IA Order and Referring Only - DentistPractitioner - Dentist 6103127972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08568IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa ENT Center PLLC PastSince Sep 1, 2012 Accepting new patients
Hintz Family Dentistry Dentist Past Accepting new patients

Organizations & group practices 2

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": "1215129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215129600000",
    "number": "1184887630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N ANKENY BLVD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231711",
            "telephone_number": "515-965-1653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N ANKENY BLVD",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231711",
            "telephone_number": "515-965-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTZ",
        "first_name": "JERAD",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-04",
        "last_updated": "2008-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

Verify at the official NPI Registry.