Individual provider Active NPI

David A Rhodes Jr., D.D.S

  • Dentist
  • Youngstown, OH
National Provider Identifier
1477808970
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-023758 Issued in OH
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, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829001969 OH Order and Referring Only - DentistPractitioner - Dentist 0244568145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023758OHMDDentist

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

Verify at the official NPI Registry.