Active NPI
Michael Ryan Butera, D.M.D.
- Prosthodontics
- Norwood, MA
National Provider Identifier
1477990943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DN1855841
- Practice address
- 89 Access Rd Ste 26
Norwood, MA 02062 - Phone
- (781) 255-1919
- NPI assigned
- May 24, 2013
- Last updated
- Oct 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DN1855841 | MA | Primary |
Addresses
Primary practice location
89 Access Rd Ste 26
Norwood, MA 02062
Mailing address
89 Access Rd Ste 26
Norwood, MA 02062-5232
Phone (781) 255-1919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160201001489 | MA | Order and Referring Only - Dentist | 9436453164 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1855841 | MA | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Butera Dental Specialists LLC | Prosthodontics | Current | Accepting new patients |
| Southeastern New England Dental Group | Prosthodontics | Past | Accepting new patients |
Locations
89 Access Rd
Ste 26
Norwood, MA 02062
Phone (781) 255-1919
Organizations & group practices 2
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.
-
- Prosthodontics
- Norwood, MA
- NPI 1043853765
-
- Prosthodontics
- New Bedford, MA
- NPI 1922131697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1477990943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 ACCESS RD STE 26",
"city": "NORWOOD",
"state": "MA",
"postal_code": "020625232",
"telephone_number": "781-255-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 ACCESS RD STE 26",
"city": "NORWOOD",
"state": "MA",
"postal_code": "02062",
"telephone_number": "781-255-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTERA",
"first_name": "MICHAEL",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-24",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MA",
"license": "DN1855841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norwood, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.