Individual provider Active NPI

James Anderson Hoddick, D.D.S.

  • General Practice Dentistry
  • Tonawanda, NY
National Provider Identifier
1730350687
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040147-1 Issued in NY
Practice address
432 Delaware St
Tonawanda, NY 14150-3946
Phone
(716) 692-4242
Fax
(716) 694-5774
NPI assigned
Mar 19, 2008
Last updated
Mar 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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 040147-1 NY Primary

Addresses

Primary practice location

432 Delaware St
Tonawanda, NY 14150-3946

Mailing address

432 Delaware St
Tonawanda, NY 14150-3946
Phone (716) 692-4242

Other identifiers 1

IdentifierTypeStateIssuer
01219007MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160107002881 NY Order and Referring Only - DentistPractitioner - Dentist 0840592853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040147-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James a. Hoddick, D.D.S. & Thomas J. Balazs, D.D.S., L.L.P. General Practice Past 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, 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": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1730350687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 DELAWARE ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141503946",
            "telephone_number": "716-692-4242",
            "fax_number": "716-694-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 DELAWARE ST",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141503946",
            "telephone_number": "716-692-4242",
            "fax_number": "716-694-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODDICK",
        "first_name": "JAMES",
        "middle_name": "ANDERSON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040147-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01219007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.