Individual provider Active NPI

Hannah Marie Corcoran, DDS

  • Dentist
  • Jackson, OH
National Provider Identifier
1669037529
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.025724 Issued in OH
Practice address
14590 State Route 93
Jackson, OH 45640-8977
Phone
(740) 286-2826
Fax
(740) 288-1874
NPI assigned
May 7, 2019
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025724 OH Primary

Addresses

Primary practice location

14590 State Route 93
Jackson, OH 45640-8977

Mailing address

941 Market St
Piketon, OH 45661-9757
Phone (740) 289-2371

Other practice location 1

7777 US Highway 23
Piketon, OH 45661-9102
Phone (740) 289-3508

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
I20190703001787 OH Practitioner - Dentist 7911231402 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025724OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Action Committee of Pike County Current Accepting new patients
Community Action Committee of Pike County Current Accepting new patients

Locations

14590 State Route 93
Jackson, OH 45640
Phone (740) 286-2826

941 Market St
Piketon, OH 45661
Phone (740) 289-2371

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1669037529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 MARKET ST",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619757",
            "telephone_number": "740-289-2371",
            "fax_number": "740-289-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14590 STATE ROUTE 93",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456408977",
            "telephone_number": "740-286-2826",
            "fax_number": "740-288-1874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 US Highway 23",
            "address_purpose": "LOCATION",
            "city": "Piketon",
            "state": "OH",
            "postal_code": "456619102",
            "country_code": "US",
            "telephone_number": "740-289-3508",
            "fax_number": "740-289-8951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

Verify at the official NPI Registry.