Anthony Frank Nottage III, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5938 Issued in NC

Practice address

3608 N Elm St
Suite B
Greensboro, NC 27455-2743

Phone

(336) 274-3791

Fax

(336) 235-2446

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NC

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

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790901858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 N ELM ST",
            "address_2": "SUITE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552743",
            "telephone_number": "336-274-3791",
            "fax_number": "336-235-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 N ELM ST",
            "address_2": "SUITE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552743",
            "telephone_number": "336-274-3791",
            "fax_number": "336-235-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTAGE",
        "first_name": "ANTHONY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "5938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Dentist in North Carolina

• 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.