Individual provider Active NPI

Michael Stewart Hipp, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Des Moines, IA
National Provider Identifier
1629282587
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
6654 Issued in IA
Practice address
4231 University Ave
Des Moines, IA 50311-3496
Phone
(515) 274-2511
Fax
(515) 234-1206
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6654 IA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 4648 NC

Addresses

Primary practice location

4231 University Ave
Des Moines, IA 50311-3496

Mailing address

4231 University Ave
Des Moines, IA 50311-3496
Phone (515) 274-2511

Other identifiers 1

IdentifierTypeStateIssuer
0185256MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6654IAMDOrthodontics and Dentofacial Orthopedic Dentist
4648NCMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629282587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113496",
            "telephone_number": "515-274-2511",
            "fax_number": "515-234-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113496",
            "telephone_number": "515-274-2511",
            "fax_number": "515-234-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIPP",
        "first_name": "MICHAEL",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IA",
            "license": "6654",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "4648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185256",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.