Individual provider Active NPI

Robert Rutner, DDS

  • General Practice Dentistry
  • Mountain View, CA
National Provider Identifier
1629180617
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33512 Issued in CA
Practice address
1040 Grant Rd
Ste 105
Mountain View, CA 94040
Phone
(650) 938-8127
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 33512 CA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 33512 CA

Addresses

Primary practice location

1040 Grant Rd
Ste 105
Mountain View, CA 94040

Mailing address

1040 Grant Rd
Ste 105
Mountain View, CA 94040
Phone (650) 938-8127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140915001387 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 3577782127 Practice locations: Mountain View, CA; Belmont, CA; San Jose, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
33512CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Road Dental General Practice Past Accepting new patients
Sapana Kothary, a Dental Corporation PastSince Jan 1, 2018 Accepting new patients
Nancy Jiang Dental Group Inc PastSince Oct 20, 2019 Accepting new patients

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1629180617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 GRANT RD",
            "address_2": "STE 105",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94040",
            "telephone_number": "650-938-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GRANT RD",
            "address_2": "STE 105",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94040",
            "telephone_number": "650-938-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTNER",
        "first_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33512",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "33512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.