Individual provider Active NPI

Don Martin Rubisch, DDS

  • Dentist
  • Draper, UT
National Provider Identifier
1275675514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
90144882-9921 Issued in UT
Practice address
946 E Draper Pkwy
Draper, UT 84020-9778
Phone
(801) 553-2521
NPI assigned
Feb 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X 90144882-9921 UT Primary

Addresses

Primary practice location

946 E Draper Pkwy
Draper, UT 84020-9778

Mailing address

946 E Draper Pkwy
Draper, UT 84020-9778
Phone (801) 553-2521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20160128000352 UT Order and Referring Only - DentistPractitioner - Dentist 6800199647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90144882-9921UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
McKay a Lewis 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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275675514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 E DRAPER PKWY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209778",
            "telephone_number": "801-553-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 E DRAPER PKWY",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209778",
            "telephone_number": "801-553-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBISCH",
        "first_name": "DON",
        "middle_name": "MARTIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "90144882-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.