Individual provider Active NPI

Rex Travis Butler, DDS

  • Periodontics
  • Phoenix, AZ
National Provider Identifier
1245348705
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6876 Issued in AZ
Practice address
6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907
Phone
(602) 281-2717
NPI assigned
Aug 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 14729 TX
Periodontics 1223P0300X 2490 AR
Periodontics 1223P0300X 6876 AZ Primary

Addresses

Primary practice location

6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907

Mailing address

6601 N Arizona Biltmore Cir
Phoenix, AZ 85016-8907
Phone (602) 281-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160916002024 AZ Order and Referring Only - Other (Non-Physician) 5698062719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14729TXMDClinical Social Worker
2490ARMDPeriodontist
6876AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1245348705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 N ARIZONA BILTMORE CIR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168907",
            "telephone_number": "602-281-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 N ARIZONA BILTMORE CIR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168907",
            "telephone_number": "602-281-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "REX",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "14729",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "2490",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.