Rick M Dougherty, DDS, ABGD, NDBA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3374 Issued in AZ

Practice address

18301 N 79TH Ave
G-185
Glendale, AZ 85308-8463

Phone

(623) 931-9197

Fax

(623) 937-4385

NPI assigned

Feb 1, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Center for Implants, Facial, and Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Glendale, AZ
  • NPI 1063529394
  NPD (past)
• Hospital Oral Surgical Services, PLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Glendale, AZ
  • NPI 1881872554
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1013055300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE",
            "address_2": "G-185",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088463",
            "telephone_number": "623-931-9197",
            "fax_number": "623-937-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE",
            "address_2": "G-185",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088463",
            "telephone_number": "623-931-9197",
            "fax_number": "623-937-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "RICK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS, ABGD, NDBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D3374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee E Doss, O.D.
• Patrick Michael Dostal, D.D.S
• David A Doty, LMSW
• Dona Mae Dougherty, NP-C
• George Michael Dougherty III, DDS
• Shireen D Dow, RD
• Nicole Dowd
• Winter M Dowland, D.O.
• Erin Dowling, LCSW
• Brent Downey, BA, BHT

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.