Active NPI
Butler Redd III, DDS
- General Practice Dentistry
- New York, NY
National Provider Identifier
1346459799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 044714-1
- Practice address
- 231 W 96TH St Apt 2B
New York, NY 10025-6311 - Phone
- (917) 886-0965
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 044714-1 | NY | Primary |
Addresses
Primary practice location
231 W 96TH St Apt 2B
New York, NY 10025-6311
Mailing address
231 W 96TH St Apt 2B
New York, NY 10025-6311
Phone (917) 886-0965
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044714-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401840000000",
"number": "1346459799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 W 96TH ST APT 2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100256311",
"telephone_number": "917-886-0965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 W 96TH ST APT 2B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100256311",
"telephone_number": "917-886-0965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDD",
"first_name": "BUTLER",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2014-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "044714-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.