DR. GREG BRIAN OTTO, D.M.D. - NPI NUMBER 1629097308

Summary

Provider Name: DR. GREG BRIAN OTTO, D.M.D.

NPI Number: 1629097308

Clasification: Dentist (1223G0001X)

Specialization: General Practice

Address:
12711 SE MILL PLAIN BLVD
VANCOUVER, WA
ZIP 98684

Phone Number: (360) 896-4484



Detailed Information

DR. Greg Brian Otto, D.M.D. is a general practice dentist in Vancouver, WA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. The assigned NPI number for this provider is 1629097308 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

12711 SE MILL PLAIN BLVD
VANCOUVER, WA
ZIP 98684-053
Phone: (360) 896-4484

The enumeration date for this NPI number is 7/19/2006 and was last updated on 7/8/2007.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1023037637 DR. JOHN ROBERT SUNDELL, D.D.S.
Dentist (General Practice)
1023184033 MRS. KRISTINE H PHAM, DMD
Dentist (General Practice)
1023323144 NUTTER & WILSON PLLC
Dentist (General Practice)
1023030111 DR. SUSAN MARIE KARAGIANES, DMD
Dentist (General Practice)
1013015452 FRANK JAMES FOREMAN, DDS
Dentist (Pediatric Dentistry)
1013109115 CANEPA DENTAL, LLC
Dentist (General Practice)
1033131909 DR. REMIGIUS JOSEPH EUSSEN, DDS
Dentist (Pediatric Dentistry)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 1223G0001X Dentist General Practice 5466 WA Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1629097308 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name OTTO The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name GREG The first name of the provider, if the provider is an individual.
5 Provider Middle Name BRIAN The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text D.M.D. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 12711 SE MILL PLAIN BLVD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name VANCOUVER The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name WA The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 986846053 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 3608964484 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 7/19/2006 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 7/8/2007 The date that a record was last updated or changed.
16 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 1223G0001X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 5466 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 WA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.