Individual provider Active NPI

William Joseph Esicar, D.M.D

  • Dentist
  • Hannibal, MO
National Provider Identifier
1720237399
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
MO12364 Issued in MO
Practice address
2903 Saint Marys Ave
Hannibal, MO 63401-3714
Phone
(573) 221-0440
Fax
(573) 221-0440
NPI assigned
Sep 18, 2008
Last updated
Sep 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X MO12364 MO Primary

Addresses

Primary practice location

2903 Saint Marys Ave
Hannibal, MO 63401-3714

Mailing address

2903 Saint Marys Ave
Hannibal, MO 63401-3714
Phone (573) 221-0440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160217001112 MO Order and Referring Only - DentistPractitioner - Dentist 0547565228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MO12364MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
William J. Esicar, D.M.D., P.C. Past Accepting new patients
Michael E McKenzie Jr, DDS LLC Dentist 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, 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": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1720237399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 SAINT MARYS AVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013714",
            "telephone_number": "573-221-0440",
            "fax_number": "573-221-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 SAINT MARYS AVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013714",
            "telephone_number": "573-221-0440",
            "fax_number": "573-221-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESICAR",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "MO12364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.