Individual provider Active NPI

Darren James Dotson, DDS

  • General Practice Dentistry
  • Spirit Lake, IA
National Provider Identifier
1649374901
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8214 Issued in IA
Practice address
1510 D Hill Avenue
Spirit Lake, IA 51360
Phone
(712) 336-4895
Fax
(712) 336-3336
NPI assigned
Sep 8, 2006
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8214 IA Primary

Addresses

Primary practice location

1510 D Hill Avenue
Spirit Lake, IA 51360

Mailing address

1510 D Hill Avenue
PO Box 448
Spirit Lake, IA 51360
Phone (712) 336-4895

Other identifiers 2

IdentifierTypeStateIssuer
0292250MedicaidIA
35337OtherIABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160104000886 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557663838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8214IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Avenue Dental LLC General Practice PastSince Mar 24, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649374901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 D HILL AVENUE",
            "address_2": "PO BOX 448",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-4895",
            "fax_number": "712-336-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 D HILL AVENUE",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "51360",
            "telephone_number": "712-336-4895",
            "fax_number": "712-336-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "DARREN",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292250",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35337",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spirit Lake, IA

Sources for this page

Verify at the official NPI Registry.