Individual provider Active NPI

Mackenzie Hoban

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1831621069
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.025347 Issued in OH
Practice address
234 Goodman St
Ucmc Dental Center
Cincinnati, OH 45219-2364
Phone
(513) 584-6660
Fax
(513) 584-6661
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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 30.025347 OH Primary

Addresses

Primary practice location

234 Goodman St
Ucmc Dental Center
Cincinnati, OH 45219-2364

Mailing address

231 Albert Sabin Way
Cincinnati, OH 45267-0769
Phone (513) 584-6660

Other names 1

  • Mack Hoban Other name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718003561 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385914738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025347OHMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1831621069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452670769",
            "telephone_number": "513-584-6660",
            "fax_number": "513-584-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "address_2": "UCMC DENTAL CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-6660",
            "fax_number": "513-584-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBAN",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACK",
            "last_name": "HOBAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.