Individual provider Active NPI

Richard Flottmann, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1952509747
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2136 Issued in AZ
Practice address
2330 N 75TH Ave
Phoenix, AZ 85035-1200
Phone
(623) 849-0477
Fax
(623) 849-6111
NPI assigned
Jul 3, 2007
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
General Practice Dentistry 1223G0001X 2136 AZ Primary

Addresses

Primary practice location

2330 N 75TH Ave
Phoenix, AZ 85035-1200

Mailing address

2330 N 75TH Ave
Phoenix, AZ 85035-1200
Phone (623) 849-0477

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
2136AZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952509747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 N 75TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850351200",
            "telephone_number": "623-849-0477",
            "fax_number": "623-849-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N 75TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850351200",
            "telephone_number": "623-849-0477",
            "fax_number": "623-849-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOTTMANN",
        "first_name": "RICHARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.