National Provider Identifier

The National Provider Identifier is a unique, government-issued, standard identification number for individual health care providers and provider organizations such as clinics, hospitals, schools and group practices. NPIs that specify an individual, such as a solo practice dentist, are classified as Entity Type 1 (Individuals) NPIs. NPIs that specify a dental practice organization are classified as Entity Type 2 (Organizations) NPIs.

Any health care provider that uses electronic transactions—like claims or eligibility verifications—is considered a “covered entity” under the Health Insurance Portability and Accountability Act (“HIPAA”) standard and is required under federal law to include an NPI on electronic transactions. This definition applies regardless of whether the provider submits electronic transactions directly or via a third party, like a vendor or a clearinghouse.

Under the HIPAA administrative simplification rules, all dentists who are covered entities must apply for and use a National Provider Identifier (NPI).

Learn More About and Apply for NPI Here