Individual provider Active NPI

Grant Oscar Hunsicker, D.D.S.

  • General Practice Dentistry
  • Tallmadge, OH
National Provider Identifier
1699119529
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023740 Issued in OH
Practice address
150 West Ave
Tallmadge, OH 44278-2296
Phone
(330) 730-4454
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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 30-023740 OH Primary

Addresses

Primary practice location

150 West Ave
Tallmadge, OH 44278-2296

Mailing address

9978 Beverly LN
Streetsboro, OH 44241-4986
Phone (330) 730-4454

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
I20150826000227 OH Order and Referring Only - DentistPractitioner - Dentist 3779899471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023740OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hunsicker Family Dental, Inc CurrentSince Jul 17, 2013 Accepting new patients

Locations

150 West Ave
Tallmadge, OH 44278
Phone (330) 633-4000

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1699119529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9978 BEVERLY LN",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414986",
            "telephone_number": "330-730-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WEST AVE",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782296",
            "telephone_number": "330-730-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNSICKER",
        "first_name": "GRANT",
        "middle_name": "OSCAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallmadge, OH

Sources for this page

Verify at the official NPI Registry.