Individual provider Active NPI

Thomas P Heckler, DDS

  • Periodontics
  • Lima, OH
National Provider Identifier
1609979582
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30014435 Issued in OH
Practice address
1337 N Cable Rd
Ste B
Lima, OH 45805
Phone
(419) 228-8929
Fax
(419) 228-0388
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 30014435 OH Primary

Addresses

Primary practice location

1337 N Cable Rd
Ste B
Lima, OH 45805

Mailing address

1337 N Cable Rd
Ste B
Lima, OH 45805
Phone (419) 228-8929

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
I20140401001368 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577794734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30014435OHMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1609979582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 N CABLE RD",
            "address_2": "STE B",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45805",
            "telephone_number": "419-228-8929",
            "fax_number": "419-228-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 N CABLE RD",
            "address_2": "STE B",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45805",
            "telephone_number": "419-228-8929",
            "fax_number": "419-228-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKLER",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30014435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.