Individual provider Active NPI

Scott Segal, DDS

  • Dentist
  • Angier, NC
National Provider Identifier
1063863496
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10431 Issued in NC
Practice address
15 Rawls Rd
Angier, NC 27501-6033
Phone
(919) 586-8372
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10431 NC Primary

Addresses

Primary practice location

15 Rawls Rd
Angier, NC 27501-6033

Mailing address

3731 SW Durham Dr
Apt 301
Durham, NC 27707-3786
Phone (704) 258-3325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20170428001464 NC Order and Referring Only - DentistPractitioner - Dentist 7618254608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10431NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1063863496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 SW DURHAM DR",
            "address_2": "APT 301",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073786",
            "telephone_number": "704-258-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RAWLS RD",
            "city": "ANGIER",
            "state": "NC",
            "postal_code": "275016033",
            "telephone_number": "919-586-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angier, NC

Sources for this page

Verify at the official NPI Registry.