Thomas Patrick Dougherty, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

G10000905 Issued in DE

Practice address

5317 Limestone Rd
Wilmington, DE 19808-1252

Phone

(302) 239-2500

Fax

(302) 239-0550

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Thomas P Dougherty Oral Maxillofacial Surgery PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Wilmington, DE
  • NPI 1245403286
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1043374515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081035",
            "telephone_number": "302-239-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081252",
            "telephone_number": "302-239-2500",
            "fax_number": "302-239-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "THOMAS",
        "middle_name": "PATRICK",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "G10000905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000912501",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "54490",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John W Dougherty III, DO
• Laura Ann Dougherty, DDS
• Laura Semon Dougherty, PT
• Margaret Dougherty, M.D.
• Taylor Paige Dougherty, DC, CD(DONA)
• Jenna Douglass
• Doula Right Thing LLC
• Dorinda Faye Dove, CNM
• Allison Taylor Dovi, PH.D
• John Dowling, L.P.C.M.H., C.A.D.C.

• Oral and Maxillofacial Surgery (Dentist) in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.