Active NPI
Robert M Dillard, DDS
- Dentist
- Okanogan, WA
National Provider Identifier
1245202829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00010710
- Practice address
- 626 Second Ave
Okanogan, WA 98840-1340 - Phone
- (509) 422-6705
- Fax
- (509) 422-6708
- NPI assigned
- Feb 7, 2006
- Last updated
- Nov 3, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00010710 | WA | Primary |
| General Practice Dentistry | 1223G0001X | 186 | CO |
Addresses
Primary practice location
626 Second Ave
Okanogan, WA 98840-1340
Mailing address
PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-7618
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160516001591 | WA | Order and Referring Only - Other (Non-Physician) | 4183913031 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010710 | WA | MD | Dentist |
| 186 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1245202829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1340",
"city": "OKANOGAN",
"state": "WA",
"postal_code": "988401340",
"telephone_number": "509-422-7618",
"fax_number": "509-422-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 SECOND AVE",
"city": "OKANOGAN",
"state": "WA",
"postal_code": "988401340",
"telephone_number": "509-422-6705",
"fax_number": "509-422-6708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLARD",
"first_name": "ROBERT",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00010710",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "186",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Okanogan, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.