Active NPI
Andrew Charles Hartwig, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Iowa City, IA
National Provider Identifier
1992712350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 07663
- Practice address
- 2814 Northgate Dr
Suite 2
Iowa City, IA 52245-9568 - Phone
- (319) 338-5484
- Fax
- (319) 338-9413
- NPI assigned
- Aug 1, 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 07663 | IA | Primary |
Addresses
Primary practice location
2814 Northgate Dr
Suite 2
Iowa City, IA 52245-9568
Mailing address
2814 Northgate Dr
Suite 2
Iowa City, IA 52245-9568
Phone (319) 338-5484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0206797 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2019 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07663 | IA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992712350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2814 NORTHGATE DR",
"address_2": "SUITE 2",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522459568",
"telephone_number": "319-338-5484",
"fax_number": "319-338-9413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2814 NORTHGATE DR",
"address_2": "SUITE 2",
"city": "IOWA CITY",
"state": "IA",
"postal_code": "522459568",
"telephone_number": "319-338-5484",
"fax_number": "319-338-9413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTWIG",
"first_name": "ANDREW",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IA",
"license": "07663",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0206797",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Iowa City, IA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.