Jordan David Hottenstein, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS 037862 Issued in PA

Practice address

First and Peach Streets
Leesport, PA 19533-0724

Phone

(610) 926-5705

Fax

(610) 926-6446

NPI assigned

Feb 1, 2013

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

Medicare fee-for-service enrollment

Enrolled in PA

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": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1639418254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 724",
            "address_2": "FIRST AND PEACH STREETS",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195330724",
            "telephone_number": "610-926-5705",
            "fax_number": "610-926-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIRST AND PEACH STREETS",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195330724",
            "telephone_number": "610-926-5705",
            "fax_number": "610-926-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTTENSTEIN",
        "first_name": "JORDAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS 037862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Leesport, PA
• Providers in Leesport, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.