Active NPI
John Randal Buttram, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Panama City, FL
National Provider Identifier
1962673970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN11224
- Practice address
- 2335 A State Ave
Panama City, FL 32405 - Phone
- (850) 785-5500
- Fax
- (850) 785-1277
- NPI assigned
- Mar 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN11224 | FL | Primary |
Addresses
Primary practice location
2335 A State Ave
Panama City, FL 32405
Mailing address
2335 A State Ave
Panama City, FL 32405
Phone (850) 785-5500
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN11224 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1962673970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2335 A STATE AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "32405",
"telephone_number": "850-785-5500",
"fax_number": "850-785-1277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2335 A STATE AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "32405",
"telephone_number": "850-785-5500",
"fax_number": "850-785-1277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTTRAM",
"first_name": "JOHN",
"middle_name": "RANDAL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-18",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "FL",
"license": "DN11224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.