Individual provider Active NPI

Madeline Neumayer Utterback, DMD

  • General Practice Dentistry
  • Fishkill, NY
National Provider Identifier
1437366499
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042806-1 Issued in NY
Practice address
1499 Route 52 Ste 25
Fishkill, NY 12524-1625
Phone
(845) 897-5140
Fax
(845) 897-5141
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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 042806-1 NY Primary

Addresses

Primary practice location

1499 Route 52 Ste 25
Fishkill, NY 12524-1625

Mailing address

1499 Route 52 Ste 25
Fishkill, NY 12524-1625
Phone (845) 897-5140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150630000913 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850603101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042806-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1437366499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 ROUTE 52 STE 25",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241625",
            "telephone_number": "845-897-5140",
            "fax_number": "845-897-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 ROUTE 52 STE 25",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241625",
            "telephone_number": "845-897-5140",
            "fax_number": "845-897-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTERBACK",
        "first_name": "MADELINE",
        "middle_name": "NEUMAYER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042806-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.