Kevin J. Hyatt, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30. 017356 Issued in OH

Practice address

301 East Ave
Elyria, OH 44035-5736

Phone

(440) 323-2523

Fax

(440) 323-2690

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609880772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EAST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355736",
            "telephone_number": "440-323-2523",
            "fax_number": "440-323-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EAST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355736",
            "telephone_number": "440-323-2523",
            "fax_number": "440-323-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYATT",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30. 017356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0542943",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Elyria, OH
• Providers in Elyria, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.