Individual provider Active NPI

Victoria L Prutz, DMD

  • General Practice Dentistry
  • York, PA
National Provider Identifier
1851602288
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-023616 Issued in OH
Practice address
1001 S George St
York, PA 17403-3676
Phone
(717) 851-4751
Fax
(717) 851-3565
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-023616 OH Primary

Addresses

Primary practice location

1001 S George St
York, PA 17403-3676

Mailing address

27127 Chardon Rd
Richmond Heights, OH 44143-1115
Phone (440) 943-1117

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

State licenses

LicenseStateTypeSpecialty
30-023616OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan J Klineman DDS Inc. Family Dentistry General Practice Past Accepting new patients
Richmond Heights Dental Arts LLC General Practice PastSince Nov 10, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1851602288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27127 CHARDON RD",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "441431115",
            "telephone_number": "440-943-1117",
            "fax_number": "440-943-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033676",
            "telephone_number": "717-851-4751",
            "fax_number": "717-851-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTZ",
        "first_name": "VICTORIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-023616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.