Individual provider Active NPI

David Anthony Jarrin, D.D.S.

  • General Practice Dentistry
  • Moline, IL
National Provider Identifier
1710033840
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.015550 Issued in IL
Practice address
1828 Avenue of the Cities
Moline, IL 61265-4828
Phone
(309) 764-0008
Fax
(309) 764-0059
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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 019.015550 IL Primary

Addresses

Primary practice location

1828 Avenue of the Cities
Moline, IL 61265-4828

Mailing address

1828 Avenue of the Cities
Moline, IL 61265-4828
Phone (309) 764-0008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
019.015550ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
QC Cpap Direct, LLC Past Accepting new patients
Myotech, LLC General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1710033840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 AVENUE OF THE CITIES",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654828",
            "telephone_number": "309-764-0008",
            "fax_number": "309-764-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 AVENUE OF THE CITIES",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654828",
            "telephone_number": "309-764-0008",
            "fax_number": "309-764-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRIN",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.015550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.