Richard E. Offutt, DDS, PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4673 Issued in NC

Legal business name

RICHARD E. OFFUTT, DDS, PA

Practice address

6719 Fairview Rd
Charlotte, NC 28210-6355

Phone

(704) 366-2774

Fax

(704) 366-2639

NPI assigned

Feb 29, 2008

Organization subpart

No

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

Authorized official

Name

Richard E Offutt, DDS

Title

President

Phone

(704) 366-2744

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1487823845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282106355",
            "telephone_number": "704-366-2774",
            "fax_number": "704-366-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282106355",
            "telephone_number": "704-366-2774",
            "fax_number": "704-366-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E. OFFUTT, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "OFFUTT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-366-2744",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "4673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Richard a. Dougherty, MD, PA
• Richard F Dest, DDS, PLLC
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• Richard J Pockat DDS PA
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• Richard W. Zollinger II, P.a.

• Periodontics in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Periodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.