Individual provider Active NPI

Robert Scott Barry, DDS

  • General Practice Dentistry
  • Greenville, OH
National Provider Identifier
1780779652
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-022689 Issued in OH
Practice address
1113 E Main St Unit a
Greenville, OH 45331
Phone
(937) 548-8005
Fax
(937) 548-9155
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12010137B IN
General Practice Dentistry 1223G0001X 30-022689 OH Primary

Addresses

Primary practice location

1113 E Main St Unit a
Greenville, OH 45331

Mailing address

1113 E Main St Unit a
Greenville, OH 45331-2987
Phone (937) 548-8005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150402000541 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2961729892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12010137BINMDDentist
30-022689OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1780779652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 E MAIN ST UNIT A",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312987",
            "telephone_number": "937-548-8005",
            "fax_number": "937-548-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 E MAIN ST UNIT A",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-8005",
            "fax_number": "937-548-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010137B",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, OH

Sources for this page

Verify at the official NPI Registry.