Active NPI
Joshua Daniel Phillips, D.M.D.
- Dentist
- Bowling Green, KY
National Provider Identifier
1376920108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9733
- Practice address
- 740 E 10TH Ave
Bowling Green, KY 42101-2318 - Phone
- (270) 781-9260
- Fax
- (270) 782-6461
- NPI assigned
- Apr 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9733 | KY | Primary |
Addresses
Primary practice location
740 E 10TH Ave
Bowling Green, KY 42101-2318
Mailing address
PO Box 9577
Bowling Green, KY 42102-9577
Phone (270) 781-9260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224001626 | IL | Order and Referring Only - Oral Surgery | 8628373909 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9733 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1376920108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9577",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421029577",
"telephone_number": "270-781-9260",
"fax_number": "270-782-6461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 E 10TH AVE",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421012318",
"telephone_number": "270-781-9260",
"fax_number": "270-782-6461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JOSHUA",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-30",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "9733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.