Individual provider Active NPI

Joseph S Tutor, DDS

  • Dentist
  • Liverpool, NY
National Provider Identifier
1821168188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0439931 Issued in NY
Practice address
4820 West Taft Road
Suite 101 West Taft Medical Park
Liverpool, NY 13088
Phone
(315) 451-4900
Fax
(315) 451-6192
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0439931 NY Primary

Addresses

Primary practice location

4820 West Taft Road
Suite 101 West Taft Medical Park
Liverpool, NY 13088

Mailing address

4820 West Taft Road
Suite 101
Liverpool, NY 13088
Phone (315) 451-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160415000826 NY Order and Referring Only - DentistPractitioner - Dentist 7416255047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0439931NYMDDentist
043993NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821168188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 WEST TAFT ROAD",
            "address_2": "SUITE 101",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-451-4900",
            "fax_number": "315-451-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 WEST TAFT ROAD",
            "address_2": "SUITE 101 WEST TAFT MEDICAL PARK",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-451-4900",
            "fax_number": "315-451-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTOR",
        "first_name": "JOSEPH",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0439931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.