Individual provider Active NPI

David Michael Horn, DDS

  • Endodontics
  • Fort Sill, OK
National Provider Identifier
1366578262
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
23329 Issued in TX
Practice address
2776 Ringold Rd
Attn: USA Dentac, Renee Chase
Fort Sill, OK 73503-4449
Phone
(580) 442-3905
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23138 NJ
Endodontics 1223E0200X 23329 TX Primary

Addresses

Primary practice location

2776 Ringold Rd
Attn: USA Dentac, Renee Chase
Fort Sill, OK 73503-4449

Mailing address

2776 Ringold Rd
Attn: USA Dentac, Renee Chase
Fort Sill, OK 73503-4449
Phone (580) 442-3905

Other identifiers 1

IdentifierTypeStateIssuer
0109339MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Oklahoma College of Dentistry, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1851 Macgregor Downs Rd
Greenville, NC 27834-5925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23329TXMDEndodontist
23138NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1366578262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 RINGOLD RD",
            "address_2": "ATTN: USA DENTAC, RENEE CHASE",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034449",
            "telephone_number": "580-442-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 RINGOLD RD",
            "address_2": "ATTN: USA DENTAC, RENEE CHASE",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034449",
            "telephone_number": "580-442-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "23138",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "23329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0109339",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.