Individual provider Active NPI

Robert M Dutton, DDS

  • Dentist
  • West Hurley, NY
National Provider Identifier
1679638282
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
033866 Issued in NY
Practice address
275 State Route 375
Suite One
West Hurley, NY 12491-5633
Phone
(845) 679-9744
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

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 033866 NY Primary

Addresses

Primary practice location

275 State Route 375
Suite One
West Hurley, NY 12491-5633

Mailing address

275 State Route 375
Suite One
West Hurley, NY 12491-5633
Phone (845) 679-9744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160325000698 NY Order and Referring Only - DentistPractitioner - Dentist 3476850074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679638282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 STATE ROUTE 375",
            "address_2": "SUITE ONE",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124915633",
            "telephone_number": "845-679-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 STATE ROUTE 375",
            "address_2": "SUITE ONE",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124915633",
            "telephone_number": "845-679-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "033866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hurley, NY

Sources for this page

Verify at the official NPI Registry.