Individual provider Active NPI

Rodney L Andrus, DDS, MS

  • Prosthodontics
  • St George, UT
National Provider Identifier
1891907655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
47486539923 Issued in UT
Practice address
640 E 700 S
Ste 104
St George, UT 84770-4023
Phone
(435) 674-3100
NPI assigned
May 4, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Prosthodontics 1223P0700X 47486539923 UT Primary

Addresses

Primary practice location

640 E 700 S
Ste 104
St George, UT 84770-4023

Mailing address

640 E 700 S
Ste 104
St George, UT 84770-4023
Phone (435) 674-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20151119000366 UT Practitioner - Oral Surgery 2668772948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
47486539923UTMDProsthodontist

Organizations & group practices 1

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891907655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E 700 S",
            "address_2": "STE 104",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704023",
            "telephone_number": "435-674-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S",
            "address_2": "STE 104",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704023",
            "telephone_number": "435-674-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "RODNEY",
        "middle_name": "L",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "UT",
            "license": "47486539923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.