Joseph Matthew Rhodes, D.D.S.

Individual provider Active NPI General Practice Dentistry · Brookville, OH

NPI 1245593243 · NPPES record last updated Jun 25, 2012

Key facts

NPI
1245593243
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
30.023757 (OH)
Practice address
480 Rona Pkwy
Brookville, OH 45309-1118
Phone
(937) 833-5247
Fax
(937) 833-1517
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160708002215 OH Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
5890087936

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
30.023757OHMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.023757 OH Yes

Addresses

Primary practice location

480 Rona Pkwy
Brookville, OH 45309-1118

Mailing address

480 Rona Pkwy
Brookville, OH 45309-1118
Phone (937) 833-5247

Other providers in Brookville, OH

All providers in Brookville, OH · General Practice Dentistry in Ohio

Sources for this page

Verify at the official NPI Registry.