Individual provider Active NPI

Faramolu Owokotomo Hurt, DDS

  • General Practice Dentistry
  • Lima, OH
National Provider Identifier
1396310975
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.026452 Issued in OH
Practice address
2765 Fort Amanda Rd Ste 200
Lima, OH 45805-4813
Phone
(419) 979-2071
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.026452 OH Primary

Addresses

Primary practice location

2765 Fort Amanda Rd Ste 200
Lima, OH 45805-4813

Mailing address

1375 Holly Ave Apt 208
Columbus, OH 43212-3294
Phone (419) 979-2071

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.026452OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1396310975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 HOLLY AVE APT 208",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123294",
            "telephone_number": "419-979-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 FORT AMANDA RD STE 200",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054813",
            "telephone_number": "419-979-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURT",
        "first_name": "FARAMOLU",
        "middle_name": "OWOKOTOMO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.