Individual provider Active NPI

Daniel Gilbert Schruth

  • Dentist
  • Puyallup, WA
National Provider Identifier
1114273422
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 60298421 Issued in WA
Practice address
1002 N Meridian Ste A104
Puyallup, WA 98371-4409
Phone
(253) 848-1874
NPI assigned
Jul 24, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE 60298421 WA Primary

Addresses

Primary practice location

1002 N Meridian Ste A104
Puyallup, WA 98371-4409

Mailing address

1002 N Meridian Ste A104
Puyallup, WA 98371-4409
Phone (253) 848-1874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109003254 WA Order and Referring Only - Other (Non-Physician) 0446531263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE 60298421WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Volland DDS PLLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1114273422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N MERIDIAN STE A104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714409",
            "telephone_number": "253-848-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MERIDIAN STE A104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983714409",
            "telephone_number": "253-848-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRUTH",
        "first_name": "DANIEL",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60298421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.