Individual provider Active NPI

Gregory Todd Hutchens, D.D.S.

  • General Practice Dentistry
  • Stuart, VA
National Provider Identifier
1043308513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401007793 Issued in VA
Practice address
112 E. Blue Ridge St.
Stuart, VA 24171-0705
Phone
(276) 694-3177
Fax
(276) 694-4439
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 0401007793 VA Primary

Addresses

Primary practice location

112 E. Blue Ridge St.
Stuart, VA 24171-0705

Mailing address

PO Box 705
112 E. Blue Ridge St.
Stuart, VA 24171-0705
Phone (276) 694-3177

Other identifiers 1

IdentifierTypeStateIssuer
045494OtherVABLUE CROSS (ANTHEM)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160330002063 VA Order and Referring Only - DentistPractitioner - Dentist 7810294220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043308513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "address_2": "112 E. BLUE RIDGE ST.",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241710705",
            "telephone_number": "276-694-3177",
            "fax_number": "276-694-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E. BLUE RIDGE ST.",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241710705",
            "telephone_number": "276-694-3177",
            "fax_number": "276-694-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHENS",
        "first_name": "GREGORY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401007793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS (ANTHEM)",
            "identifier": "045494",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, VA

Sources for this page

Verify at the official NPI Registry.