Individual provider Active NPI

Robert Drury II, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1427165398
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58493 Issued in CA
Practice address
5995 Mission Gorge Rd
Ste a
San Diego, CA 92120-4028
Phone
(760) 716-7466
Fax
(619) 282-4394
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 58493 CA Primary

Addresses

Primary practice location

5995 Mission Gorge Rd
Ste a
San Diego, CA 92120-4028

Mailing address

5995 Mission Gorge Rd
Ste a
San Diego, CA 92120-4028
Phone (760) 716-7466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160727002163 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6901199025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1427165398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 MISSION GORGE RD",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204028",
            "telephone_number": "760-716-7466",
            "fax_number": "619-282-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 MISSION GORGE RD",
            "address_2": "STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204028",
            "telephone_number": "760-716-7466",
            "fax_number": "619-282-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRURY",
        "first_name": "ROBERT",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.