Karl D Otto, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS026797L Issued in PA

Practice address

4808 Derry St
Harrisburg, PA 17111-3440

Phone

(717) 564-9250

Fax

(717) 564-9250

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• South Side Dental Care LLC

  • Dental Clinic/Center
  • Harrisburg, PA
  • NPI 1134831324
  NPD (past)
• South Side Dental Care LLC

  • General Practice Dentistry
  • Harrisburg, PA
  • NPI 1265053144
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326267527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 DERRY ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113440",
            "telephone_number": "717-564-9250",
            "fax_number": "717-564-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 DERRY ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113440",
            "telephone_number": "717-564-9250",
            "fax_number": "717-564-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "KARL",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026797L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A Osuch, LCSW
• Augustine Osula, MD
• OT & Me, LLC
• Dorcas Otoo, NP
• Otto Bock Patient Care, LLC
• Our Angels Home Care
• Our Friendly Home Care LLC
• Our Home Care LLC
• Bridget Ourada, D.O.
• Outpatient Physical Therapy Network, LLC

• General Practice Dentistry in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.