Individual provider Active NPI

David S Schlutz, DMD

  • General Practice Dentistry
  • Rockville, MD
National Provider Identifier
1194944678
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12160 Issued in MD
Practice address
4618 Randolph Rd
Rockville, MD 20852-2255
Phone
(301) 770-7369
Fax
(301) 770-7631
NPI assigned
Apr 24, 2007
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 12160 MD Primary

Addresses

Primary practice location

4618 Randolph Rd
Rockville, MD 20852-2255

Mailing address

4618 Randolph Rd
Rockville, MD 20852-2255
Phone (301) 770-7369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160610000556 MD Order and Referring Only - DentistPractitioner - Dentist 7012207608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12160MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194944678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4618 RANDOLPH RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522255",
            "telephone_number": "301-770-7369",
            "fax_number": "301-770-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 RANDOLPH RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522255",
            "telephone_number": "301-770-7369",
            "fax_number": "301-770-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUTZ",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "12160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.