Provider Demographics
NPI:1740204718
Name:HAMILTON, SCOTT D (DDS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 SW WESTPORT DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-1945
Mailing Address - Country:US
Mailing Address - Phone:785-272-3722
Mailing Address - Fax:785-272-4718
Practice Address - Street 1:2235 SW WESTPORT DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-1945
Practice Address - Country:US
Practice Address - Phone:785-272-3722
Practice Address - Fax:785-272-4718
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS008881OtherBCBS KS
KS818158OtherUNITED CONCORDIA
KST44050Medicare UPIN