Individual provider Active NPI

Robert E Langsten, DDS, ABGD,FAGD

  • Dentist
  • Eglin Afb, FL
National Provider Identifier
1407841778
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN13677 Issued in FL
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

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN13677FLMDDentist

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.

Verify at the official NPI Registry.