Active NPI
Rex William Hoover, D.D.S.
- Dentist
- San Jose, CA
National Provider Identifier
1770795163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24119
- Practice address
- 3990 S Bascom Ave
San Jose, CA 95124-2663 - Phone
- (408) 356-5161
- Fax
- (408) 559-5035
- NPI assigned
- May 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24119 | CA | Primary |
Addresses
Primary practice location
3990 S Bascom Ave
San Jose, CA 95124-2663
Mailing address
14475 Sobey Rd
Saratoga, CA 95070-5608
Phone (408) 867-4209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160322000931 | CA | Order and Referring Only - Dentist | 7214234095 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770795163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14475 SOBEY RD",
"city": "SARATOGA",
"state": "CA",
"postal_code": "950705608",
"telephone_number": "408-867-4209",
"fax_number": "408-559-5035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 S BASCOM AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951242663",
"telephone_number": "408-356-5161",
"fax_number": "408-559-5035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOVER",
"first_name": "REX",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "24119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.