Active NPI
David A Rhodes Jr., D.D.S
- Dentist
- Youngstown, OH
National Provider Identifier
1477808970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30-023758
- Practice address
- 1044 Belmont Avenue
St. Elizabeth Health Center
Youngstown, OH 44501 - Phone
- (330) 480-3795
- NPI assigned
- Jul 20, 2012
- Last updated
- Jul 20, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 30-023758 | OH | Primary |
Addresses
Primary practice location
1044 Belmont Avenue
St. Elizabeth Health Center
Youngstown, OH 44501
Mailing address
1044 Belmont Ave
St. Elizabeth Health Center
Youngstown, OH 44501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20190829001969 | OH | Order and Referring Only - Dentist | 0244568145 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-023758 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342742400000",
"number": "1477808970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1044 BELMONT AVE",
"address_2": "ST. ELIZABETH HEALTH CENTER",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "44501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 BELMONT AVENUE",
"address_2": "ST. ELIZABETH HEALTH CENTER",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "44501",
"telephone_number": "330-480-3795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODES",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-20",
"last_updated": "2012-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30-023758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.