Active NPI
Jonathan W Hill, DDS PC
- Dentist
- Colorado Springs, CO
National Provider Identifier
1790772739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7447
- Practice address
- 4711 Opus Drive Ste 120
Colorado Springs, CO 80906 - Phone
- (719) 540-3983
- Fax
- (719) 392-1589
- NPI assigned
- Oct 4, 2005
- 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 | 7447 | CO | Primary |
Addresses
Primary practice location
4711 Opus Drive Ste 120
Colorado Springs, CO 80906
Mailing address
4711 Opus Dr Ste 120
Colorado Springs, CO 80906-8649
Phone (719) 540-3983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- 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 |
|---|---|---|---|---|
| I20160917000381 | CO | Order and Referring Only - Other (Physician) | 2769779818 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7447 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1790772739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4711 OPUS DR STE 120",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809068649",
"telephone_number": "719-540-3983",
"fax_number": "719-392-1589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4711 OPUS DRIVE STE 120",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80906",
"telephone_number": "719-540-3983",
"fax_number": "719-392-1589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "JONATHAN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS PC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "7447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.