Active NPI
Robert Byron Guttry, DDS
- General Practice Dentistry
- Longview, TX
National Provider Identifier
1689787608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18946
- Practice address
- 903 Judson Rd
Longview, TX 75601-5114 - Phone
- (903) 758-0189
- Fax
- (903) 758-7970
- NPI assigned
- Aug 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18946 | LA | Primary |
Addresses
Primary practice location
903 Judson Rd
Longview, TX 75601-5114
Mailing address
903 Judson Rd
Longview, TX 75601-5114
Phone (903) 758-0189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160603000659 | TX | Order and Referring Only - Other (Physician) | 5597055509 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18946 | LA | MD | General Practice Dentistry |
| 18946 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689787608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 JUDSON RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015114",
"telephone_number": "903-758-0189",
"fax_number": "903-758-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 JUDSON RD",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756015114",
"telephone_number": "903-758-0189",
"fax_number": "903-758-7970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTTRY",
"first_name": "ROBERT",
"middle_name": "BYRON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "18946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
- Michael B Guillory, M.D.
- Ryan M Guillory, MD
- Carissa Brooke Gunathilaka, LPC
- Gabriella Marie Gunter, CPM
- Lori Guthrie, NP
- Garrett Ingram Guy, PHARM.D.
- H2 Health and Rehabilitation Services, LLC (H2 Health)
- H8Pain Pain Management Center of Texas (Sleep Study Centers of Texas)
- H8Pain Pain Management Center of Texas PLLC (The Pain Management Center of Texas)
- H8Pain Pain Management Center of Texas PLLC (The Pain Management Center of Texas)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.