Individual provider Active NPI

Robert Campbell Preston, DDS

  • Dentist
  • Gloucester, MA
National Provider Identifier
1508889494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12454 Issued in MA
Practice address
9 E Dr Osman Babson Rd
Gloucester, MA 01930-1812
Phone
(978) 281-1144
Fax
(978) 281-1144
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12454 MA Primary

Addresses

Primary practice location

9 E Dr Osman Babson Rd
Gloucester, MA 01930-1812

Mailing address

9 E Dr Osman Babson Rd
Gloucester, MA 01930-1812
Phone (978) 281-1144

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
I20150605000149 MA Order and Referring Only - DentistPractitioner - Dentist 4880915693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12454MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508889494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 E DR OSMAN BABSON RD",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301812",
            "telephone_number": "978-281-1144",
            "fax_number": "978-281-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 E DR OSMAN BABSON RD",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301812",
            "telephone_number": "978-281-1144",
            "fax_number": "978-281-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "ROBERT",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "12454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.