Individual provider Active NPI

Enrique Oltra Esplugues, D.D.S.

  • Endodontics
  • Virginia Beach, VA
National Provider Identifier
1548669740
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401414309 Issued in VA
Practice address
1724 Sir William Osler Dr
Virginia Beach, VA 23454-3003
Phone
(757) 481-1894
Fax
(757) 481-1238
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401414309 VA Primary

Addresses

Primary practice location

1724 Sir William Osler Dr
Virginia Beach, VA 23454-3003

Mailing address

1092 Blue Castle LN
Virginia Beach, VA 23454-1939
Phone (206) 335-4494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20151125001574 VA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395045207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Endodontics, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1548669740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 BLUE CASTLE LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234541939",
            "telephone_number": "206-335-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 SIR WILLIAM OSLER DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543003",
            "telephone_number": "757-481-1894",
            "fax_number": "757-481-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTRA ESPLUGUES",
        "first_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401414309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.