Provider Demographics
NPI:1780600460
Name:HOTTENSTEIN, JOYCE A (DMD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:A
Last Name:HOTTENSTEIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 ALLEN ST
Mailing Address - Street 2:SUITE #301
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4570
Mailing Address - Country:US
Mailing Address - Phone:802-775-0986
Mailing Address - Fax:802-419-3300
Practice Address - Street 1:71 ALLEN ST
Practice Address - Street 2:SUITE #301
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4570
Practice Address - Country:US
Practice Address - Phone:802-775-0986
Practice Address - Fax:802-419-3300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-0002089122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT981999OtherUNITED CONCORDIA
VT1007208Medicaid
VTBH5950591OtherDEA