Kelly Louise Buttrick, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

016.0121080 Issued in VT

Practice address

100 Macdonough Dr
Vergennes, VT 05491-1095

Phone

(802) 877-0135

NPI assigned

Mar 17, 2006

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Kelly Louise Buttrick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1356300586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 MCKINLEY AVE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057019776",
            "telephone_number": "231-631-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MACDONOUGH DR",
            "city": "VERGENNES",
            "state": "VT",
            "postal_code": "054911095",
            "telephone_number": "802-877-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTRICK",
        "first_name": "KELLY",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021173",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "DEND891",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0121080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BUTTRICK",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Vergennes, VT
• Providers in Vergennes, VT by specialty
• Dentist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.