Active NPI
J Glenn Rutherford, DDS
- General Practice Dentistry
- Pagosa Springs, CO
National Provider Identifier
1326072802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6065
- Practice address
- 51 David Dr
Pagosa Springs, CO 81147-9440 - Phone
- (970) 731-3627
- NPI assigned
- Jul 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6065 | CO | Primary |
Addresses
Primary practice location
51 David Dr
Pagosa Springs, CO 81147-9440
Mailing address
900 Black Powder PL
Pagosa Springs, CO 81147-9375
Phone (970) 731-5983
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04014924 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6065 | CO | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J. Glenn Rutherford DDS PC | General Practice | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Pagosa Springs, CO
- NPI 1063610269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1326072802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 BLACK POWDER PL",
"city": "PAGOSA SPRINGS",
"state": "CO",
"postal_code": "811479375",
"telephone_number": "970-731-5983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 DAVID DR",
"city": "PAGOSA SPRINGS",
"state": "CO",
"postal_code": "811479440",
"telephone_number": "970-731-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTHERFORD",
"first_name": "J",
"middle_name": "GLENN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "6065",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04014924",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pagosa Springs, CO
- Brandy Diane Richardson, CLC
- Erica J Robinson
- Rocky Mountain Physical Therapy & Sports Injury Center, Inc.
- Merenda Renae Romine, LMT
- Peter James Roukema, D.M.D.
- Jordan G Rutherford
- Kristin L Salisbury, OCCUPATIONAL THERAP
- San Juan Dental Hygiene LLC
- San Juan Dental LLC
- San Juan River Rehabilitation LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.