Active NPI
Vicky Suzanne Ottmers, DDS
- Public Health Dentistry
- Georgetown, TX
National Provider Identifier
1962693069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 20818
- Practice address
- 950 W University Ave
Suite 104
Georgetown, TX 78626-6505 - Phone
- (512) 864-1445
- NPI assigned
- Aug 5, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 20818 | TX | Primary |
Addresses
Primary practice location
950 W University Ave
Suite 104
Georgetown, TX 78626-6505
Mailing address
301 Peaceful Haven Way
Hutto, TX 78634-4179
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 |
|---|---|---|---|
| 20818 | TX | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186272000000",
"number": "1962693069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 PEACEFUL HAVEN WAY",
"city": "HUTTO",
"state": "TX",
"postal_code": "786344179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 W UNIVERSITY AVE",
"address_2": "SUITE 104",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786266505",
"telephone_number": "512-864-1445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTTMERS",
"first_name": "VICKY",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2007-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "TX",
"license": "20818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.