Active NPI
Robert E Langsten, DDS, ABGD,FAGD
- Dentist
- Eglin Afb, FL
National Provider Identifier
1407841778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN13677
- Practice address
- 96TH Medical Group/SGD
307 Boatner Road, Suite 114
Eglin Afb, FL 32542 - Phone
- (850) 883-8050
- Fax
- (850) 883-8328
- NPI assigned
- Sep 13, 2005
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN13677 | FL | Primary |
Addresses
Primary practice location
96TH Medical Group/SGD
307 Boatner Road, Suite 114
Eglin Afb, FL 32542
Mailing address
307 Boatner Rd
Suite 114
Eglin Afb, FL 32542-1391
Phone (850) 883-8050
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 |
|---|---|---|---|
| DN13677 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186531200000",
"number": "1407841778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 BOATNER RD",
"address_2": "SUITE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421391",
"telephone_number": "850-883-8050",
"fax_number": "850-883-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96TH MEDICAL GROUP/SGD",
"address_2": "307 BOATNER ROAD, SUITE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "32542",
"telephone_number": "850-883-8050",
"fax_number": "850-883-8328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGSTEN",
"first_name": "ROBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS, ABGD,FAGD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2007-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN13677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eglin Afb, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.