Individual provider Active NPI

Daniel Bock, D.D.S.

  • Dentist
  • Lawrence, KS
National Provider Identifier
1508170176
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60703 Issued in KS
Practice address
2415 Massachusetts St
Lawrence, KS 66046-4827
Phone
(785) 832-4854
Fax
(785) 832-4853
NPI assigned
Aug 5, 2010
Last updated
Aug 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60703 KS Primary

Addresses

Primary practice location

2415 Massachusetts St
Lawrence, KS 66046-4827

Mailing address

2415 Massachusetts St
Lawrence, KS 66046-4827
Phone (785) 832-4854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20111123000094 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456525732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60703KSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1508170176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-832-4854",
            "fax_number": "785-832-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-832-4854",
            "fax_number": "785-832-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "DANIEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.