Individual provider Active NPI

Colleen Tepe Hofstetter, DDS

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1639459589
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30023498 Issued in OH
Practice address
3507 Glenmore Ave
Cincinnati, OH 45211-5457
Phone
(513) 481-5885
Fax
(513) 481-4270
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30023498 OH Primary

Addresses

Primary practice location

3507 Glenmore Ave
Cincinnati, OH 45211-5457

Mailing address

3507 Glenmore Ave
Cincinnati, OH 45211-5457
Phone (513) 481-5885

Other names 1

  • Dr. Colleen Elise Tepe Former name

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
I20150505000692 OH Order and Referring Only - DentistPractitioner - Dentist 9739406588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30023498OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1639459589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452115457",
            "telephone_number": "513-481-5885",
            "fax_number": "513-481-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452115457",
            "telephone_number": "513-481-5885",
            "fax_number": "513-481-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFSTETTER",
        "first_name": "COLLEEN",
        "middle_name": "TEPE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "TEPE",
            "middle_name": "ELISE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.