Active NPI
Joseph L Shurtleff, DDS
- General Practice Dentistry
- Fayetteville, NC
National Provider Identifier
1790962645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6501
- Practice address
- 912 Robeson St
Fayetteville, NC 28305-5614 - Phone
- (910) 485-6136
- Fax
- (919) 485-6302
- NPI assigned
- Jan 23, 2008
- 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 | 6501 | NC | Primary |
Addresses
Primary practice location
912 Robeson St
Fayetteville, NC 28305-5614
Mailing address
912 Robeson St
Fayetteville, NC 28305-5614
Phone (910) 485-6136
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 97602 | Other | NC | BSBC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1790962645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 ROBESON ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055614",
"telephone_number": "910-485-6136",
"fax_number": "914-485-6302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 ROBESON ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283055614",
"telephone_number": "910-485-6136",
"fax_number": "919-485-6302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHURTLEFF",
"first_name": "JOSEPH",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-01-23",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "6501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSBC",
"identifier": "97602",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.