Joseph R Abt, DMD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Prescott, AZ
NPI 1295032357 · NPPES record last updated Feb 24, 2011
Key facts
- NPI
- 1295032357
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 8065 N Vista LN
Prescott, AZ 86305-8833 - Phone
- (520) 490-5141
- NPI assigned
- Feb 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161020001012 | CO | Order and Referring Only - Dentist |
6800174111 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
8065 N Vista LN
Prescott, AZ 86305-8833
Mailing address
8065 N Vista LN
Prescott, AZ 86305-8833
Phone (520) 490-5141
Other providers in Prescott, AZ
- Kamani Ngozi Abarikwu
- Delmas Lee Abbott
- Ability Two, LLC
- Bryan Lawrence Abramowitz
- Benjamin Robert Abt
- Angelita Acosta-del Rio
- Lois Karleen Acosta
- Active Life Physical Therapy Inc
- Deborah Anne Adams-Courtland
- Eileen T Adams
All providers in Prescott, AZ · Student in an Organized Health Care Education/Training Program in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.