Individual provider Active NPI

James D Hoag, DDS

  • Periodontics
  • Kalispell, MT
National Provider Identifier
1396837357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2018 Issued in MT
Practice address
430 Windward Way
Suite 201
Kalispell, MT 59901-2623
Phone
(406) 752-8805
Fax
(406) 752-9007
NPI assigned
Sep 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2018 MT Primary

Addresses

Primary practice location

430 Windward Way
Suite 201
Kalispell, MT 59901-2623

Mailing address

430 Windward Way
Suite 201
Kalispell, MT 59901-2623
Phone (406) 752-8805

Other identifiers 2

IdentifierTypeStateIssuer
0000111724MedicaidMT
20184OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160203002362 MT Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3779887203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018MTMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396837357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WINDWARD WAY",
            "address_2": "SUITE 201",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012623",
            "telephone_number": "406-752-8805",
            "fax_number": "406-752-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WINDWARD WAY",
            "address_2": "SUITE 201",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012623",
            "telephone_number": "406-752-8805",
            "fax_number": "406-752-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOAG",
        "first_name": "JAMES",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MT",
            "license": "2018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000111724",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20184",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.