Individual provider Active NPI

Parker M Jarvis, D.D.S.

  • General Practice Dentistry
  • Westerville, OH
National Provider Identifier
1861416257
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15052 Issued in OH
Practice address
555 W Schrock Rd
Suite 120
Westerville, OH 43081-8702
Phone
(614) 882-5208
Fax
(614) 882-6497
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 15052 OH Primary

Addresses

Primary practice location

555 W Schrock Rd
Suite 120
Westerville, OH 43081-8702

Mailing address

555 W Schrock Rd
Suite 120
Westerville, OH 43081-8702
Phone (614) 882-5208

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
I20170613001100 OH Order and Referring Only - DentistPractitioner - Dentist 9436397486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15052OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861416257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W SCHROCK RD",
            "address_2": "SUITE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818702",
            "telephone_number": "614-882-5208",
            "fax_number": "614-882-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W SCHROCK RD",
            "address_2": "SUITE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430818702",
            "telephone_number": "614-882-5208",
            "fax_number": "614-882-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "PARKER",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "15052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.