Active NPI
Thomas Hugo Hamilton Jr., DDS
- General Practice Dentistry
- Fayetteville, NC
National Provider Identifier
1861429284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7389
- Practice address
- 1400 Walter Reed Rd
Suite 200
Fayetteville, NC 28304-4409 - Phone
- (910) 864-9884
- Fax
- (910) 354-1399
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 7389 | NC | Primary |
Addresses
Primary practice location
1400 Walter Reed Rd
Suite 200
Fayetteville, NC 28304-4409
Mailing address
2041 Silas Creek Pkwy
Winston Salem, NC 27103-5147
Phone (336) 777-0303
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 899018U | Medicaid | NC | |
| 1940554 | Other | UNITED CONCORDIA | |
| 9018U | Other | BLUE CROSS BLUE SHIELD NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7389 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ballance & Derose DDS PA | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Fayetteville, NC
- NPI 1386677961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861429284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 SILAS CREEK PKWY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035147",
"telephone_number": "336-777-0303",
"fax_number": "336-777-3448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 WALTER REED RD",
"address_2": "SUITE 200",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044409",
"telephone_number": "910-864-9884",
"fax_number": "910-354-1399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "THOMAS",
"middle_name": "HUGO",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "7389",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "899018U",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1940554",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD NC",
"identifier": "9018U",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.