NPIMap

Individual provider Active NPI

Hector C Siordia Jr., D.D.S.

  • Dentist
  • Usaf Academy, CO
National Provider Identifier
1841585916
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413176 Issued in VA
Practice address
4102 Pinion Dr
10 MDG
Usaf Academy, CO 80840-2502
Phone
(719) 333-5192
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413176 VA Primary

Addresses

Primary practice location

4102 Pinion Dr
10 MDG
Usaf Academy, CO 80840-2502

Mailing address

4102 Pinion Dr. 10 MDG
Usaf Academy, CO 80840
Phone (719) 333-5192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715001378 PA Practitioner - Oral Surgery 0547705527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

207 S 32ND St
Wood and Myers Oral and Maxillofacial Surgeons
Camp Hill, PA 17011-5103
Phone (717) 763-1970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401413176VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wood & Myers Oral and Maxillofacial Surgery, P.C. Current Accepting new patients
Wood & Myers Oral and Maxillofacial Surgery, PC CurrentSince Aug 1, 2024 Accepting new patients
Wood & Myers Oral and Maxillofacial Surgery, PC CurrentSince Aug 1, 2024 Accepting new patients

Locations

207 S 32nd St
Camp Hill, PA 17011
Phone (717) 763-1970

25 Eastgate Dr
Carlisle, PA 17015
Phone (717) 249-7007

4341 Linglestown Rd
Harrisburg, PA 17112
Phone (717) 545-6200

230 Harrisburg Ave
Ste 3
Lancaster, PA 17603
Phone (717) 391-9003

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1841585916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR. 10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "80840",
            "telephone_number": "719-333-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIORDIA",
        "first_name": "HECTOR",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

Verify at the official NPI Registry.