Individual provider Active NPI

Troy Hutinger, D.D.S

  • General Practice Dentistry
  • Jefferson City, MO
National Provider Identifier
1427474121
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2013023617 Issued in MO
Practice address
3400 W Truman Blvd
Jefferson City, MO 65109-5712
Phone
(573) 632-2777
Fax
(573) 632-0275
NPI assigned
Mar 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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 2013023617 MO Primary

Addresses

Primary practice location

3400 W Truman Blvd
Jefferson City, MO 65109-5712

Mailing address

PO Box 104780
Jefferson City, MO 65110-4780
Phone (573) 632-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160317000420 MO Order and Referring Only - DentistPractitioner - Dentist 3779889720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013023617MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1427474121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104780",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104780",
            "telephone_number": "573-632-2777",
            "fax_number": "573-632-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095712",
            "telephone_number": "573-632-2777",
            "fax_number": "573-632-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTINGER",
        "first_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2013023617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.