Individual provider Active NPI

Patrick John Hitchan, DMD

  • General Practice Dentistry
  • Meadville, PA
National Provider Identifier
1689361255
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS044561 Issued in PA
Practice address
900 Water St Ste 16
Meadville, PA 16335-3428
Phone
(814) 333-6000
Fax
(814) 333-6001
NPI assigned
Apr 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS044561 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X NM

Addresses

Primary practice location

900 Water St Ste 16
Meadville, PA 16335-3428

Mailing address

431 Myoma Rd
Mars, PA 16046-2350
Phone (724) 355-3965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20230728002476 NM Order and Referring Only - DentistPractitioner - Dentist 4385005966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS044561PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Smiles, Inc. PastSince Jun 23, 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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1689361255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 MYOMA RD",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160462350",
            "telephone_number": "724-355-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WATER ST STE 16",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353428",
            "telephone_number": "814-333-6000",
            "fax_number": "814-333-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHAN",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044561",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.