Active NPI
Brooke Fender Hamilton, D.D.S.
- General Practice Dentistry
- Dayton, OH
National Provider Identifier
1831487685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30-023473
- Practice address
- 4100 W 3Rd St
Dental Clinic
Dayton, OH 45428-9000 - Phone
- (937) 268-6511
- NPI assigned
- Jul 14, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30-023473 | OH | Primary |
Addresses
Primary practice location
4100 W 3Rd St
Dental Clinic
Dayton, OH 45428-9000
Mailing address
4100 W 3Rd St
Dental Clinic
Dayton, OH 45428-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20150326001565 | OH | Order and Referring Only - Oral Surgery | 7214254457 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-023473 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310601600000",
"number": "1831487685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 W 3RD ST",
"address_2": "DENTAL CLINIC",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W 3RD ST",
"address_2": "DENTAL CLINIC",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "BROOKE",
"middle_name": "FENDER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-14",
"last_updated": "2011-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-023473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.