Individual provider Active NPI

Michael Ryan Butera, D.M.D.

  • Prosthodontics
  • Norwood, MA
National Provider Identifier
1477990943
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN1855841 Issued in MA
Practice address
89 Access Rd Ste 26
Norwood, MA 02062
Phone
(781) 255-1919
NPI assigned
May 24, 2013
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201001489 MA Order and Referring Only - DentistPractitioner - Dentist 9436453164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855841MAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Butera Dental Specialists LLC Prosthodontics CurrentSince Oct 27, 2019 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.

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

Verify at the official NPI Registry.