Individual provider Active NPI

Andrew Bruce Hamilton, D.D.S.

  • Dentist
  • Hartford, MI
National Provider Identifier
1275761017
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020075 Issued in MI
Practice address
57418 County Road 681 Ste a
Hartford, MI 49057-9422
Phone
(269) 621-3143
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020075 MI Primary

Addresses

Primary practice location

57418 County Road 681 Ste a
Hartford, MI 49057-9422

Mailing address

57418 County Road 681 Ste a
Hartford, MI 49057-9422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000260 MI Practitioner - Oral SurgeryPractitioner - General PracticePractitioner - Dentist 2163720970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020075MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1275761017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57418 COUNTY ROAD 681 STE A",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57418 COUNTY ROAD 681 STE A",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579422",
            "telephone_number": "269-621-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "ANDREW",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, MI

Sources for this page

Verify at the official NPI Registry.