Richard Charles Pfotenhauer, D.D.S., P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

2901013893 Issued in MI

Practice address

823 Delta Ave
Gladstone, MI 49837-1646

Phone

(906) 428-1325

NPI assigned

Jun 26, 2006

Last updated

Sep 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Richard C. Pfotenhauer Family Dentistry

  • Dental Clinic/Center
  • Gladstone, MI
  • NPI 1376262501
  NPD Authorized official

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1972530178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N 9TH ST",
            "address_2": "STE B",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498371660",
            "telephone_number": "906-428-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 DELTA AVE",
            "city": "GLADSTONE",
            "state": "MI",
            "postal_code": "498371646",
            "telephone_number": "906-428-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFOTENHAUER",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER IDENTIFICATION N",
            "identifier": "383575211",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwoods Rehabilitation Inc.
• Carley O'Neal, DPT, PT
• Charles S Olsen, DO
• Jenilee Pellegrini
• Peninsula Pharmacy Gladstone LLC
• Scott A Randall, M.D.
• Matthew Rayeski, DO
• Erik M Rubright, DO
• Joann Leano Santos
• Sierra Schiller, RN

• Dentist in Gladstone, MI
• Providers in Gladstone, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.