Individual provider Active NPI

Robert Glenn Plage, DDS

  • General Practice Dentistry
  • Wilmington, NC
National Provider Identifier
1427072131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
NC5100 Issued in NC
Practice address
1802B New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone
(910) 762-4155
Fax
(910) 763-0293
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NC5100 NC Primary

Addresses

Primary practice location

1802B New Hanover Medical Park Dr
Wilmington, NC 28403-5350

Mailing address

1802B New Hanover Medical Park Dr
Wilmington, NC 28403-5350
Phone (910) 762-4155

Other identifiers 1

IdentifierTypeStateIssuer
89-96887MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309001609 NC Order and Referring Only - DentistPractitioner - Dentist 5799081287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC5100NCMDGeneral Practice Dentistry
5100NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Plage and Eglinton DDS PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427072131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802B NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035350",
            "telephone_number": "910-762-4155",
            "fax_number": "910-763-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802B NEW HANOVER MEDICAL PARK DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035350",
            "telephone_number": "910-762-4155",
            "fax_number": "910-763-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAGE",
        "first_name": "ROBERT",
        "middle_name": "GLENN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "NC5100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-96887",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.