Active NPI
Israel Puterman, DMD MSD
- Periodontics
- Chevy Chase, MD
National Provider Identifier
1821227232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 14401
- Practice address
- 5454 Wisconsin Ave Ste 1550
Chevy Chase, MD 20815-6954 - Phone
- (301) 652-0939
- NPI assigned
- Jul 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 20633 | MA | |
| Periodontics | 1223P0300X | 053939 | NY | |
| Periodontics | 1223P0300X | 0401412265 | VA | |
| Periodontics | 1223P0300X | DEN1000796 | DC | |
| Periodontics | 1223P0300X | 14401 | MD | Primary |
Addresses
Primary practice location
5454 Wisconsin Ave Ste 1550
Chevy Chase, MD 20815-6954
Mailing address
5530 Wisconsin Ave
Suite 712
Chevy Chase, MD 20815-4404
Phone (301) 652-0939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150601000189 | DC | Order and Referring Only - Dentist | 3779804901 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1000796 | DC | MD | Periodontist |
| 20633 | MA | MD | Periodontist |
| 0401412265 | VA | MD | Periodontist |
| 053939 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1821227232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5530 WISCONSIN AVE",
"address_2": "SUITE 712",
"city": "CHEVY CHASE",
"state": "MD",
"postal_code": "208154404",
"telephone_number": "301-652-0939",
"fax_number": "301-652-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5454 WISCONSIN AVE STE 1550",
"city": "CHEVY CHASE",
"state": "MD",
"postal_code": "208156954",
"telephone_number": "301-652-0939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTERMAN",
"first_name": "ISRAEL",
"name_prefix": "Dr.",
"credential": "DMD MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-07",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "20633",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "053939",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401412265",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "DC",
"license": "DEN1000796",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "14401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chevy Chase, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.