Individual provider Active NPI

Andrew Scott Huttula, DDS

  • Endodontics
  • Huntsville, AL
National Provider Identifier
1114906187
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5599 Issued in AL
Practice address
1140 Eagletree LN SE
Suite 100
Huntsville, AL 35801-6446
Phone
(256) 533-3480
Fax
(256) 534-6915
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DS7698 TN
Endodontics 1223E0200X 5599 AL Primary

Addresses

Primary practice location

1140 Eagletree LN SE
Suite 100
Huntsville, AL 35801-6446

Mailing address

303 Williams Ave SW
Ste 1011
Huntsville, AL 35801-6097
Phone (256) 533-3480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20160229001002 AL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3678878683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS7698TNMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1114906187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 WILLIAMS AVE SW",
            "address_2": "STE 1011",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016097",
            "telephone_number": "256-533-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 EAGLETREE LN SE",
            "address_2": "SUITE 100",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016446",
            "telephone_number": "256-533-3480",
            "fax_number": "256-534-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTULA",
        "first_name": "ANDREW",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "DS7698",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AL",
            "license": "5599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.