Joseph Balzer Otto, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4550 Issued in OK

Practice address

400 Fairview Suite 1
Ponca City, OK 74601-1910

Phone

(580) 765-6633

Fax

(580) 765-0803

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Joseph B. Otto DDS, P.C.

  • Dentist
  • Ponca City, OK
  • NPI 1578748547
  NPD (past) Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710064910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW SUITE 1",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011910",
            "telephone_number": "580-765-6633",
            "fax_number": "580-765-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW SUITE 1",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011910",
            "telephone_number": "580-765-6633",
            "fax_number": "580-765-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "JOSEPH",
        "middle_name": "BALZER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Olmstead, LCSW
• Opportunity Center, Incorporated
• Opal Oranchak
• Daniel Joseph Ore, PTA
• Mackenzie Nicole Ottinger, PT, DPT
• Outpatient Surgical Center of Ponca City, LLC
• Outpatient Surgical Center of Ponca City, LLC
• Matthew Overland
• Nathaniel Page Jr.
• Pamela J Poland MD (Ponca City Eye Clinic)

• Dentist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Dentist in Oklahoma

• 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.

Verify at the official NPI Registry.