Individual provider Active NPI

Stephen Douglas Ray, D.D.S.

  • General Practice Dentistry
  • Red Bay, AL
National Provider Identifier
1104998988
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AL4540 Issued in AL
Practice address
1115 4TH St. NW
Red Bay, AL 35582
Phone
(256) 356-8899
Fax
(256) 356-4581
NPI assigned
Nov 15, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AL4540 AL Primary

Addresses

Primary practice location

1115 4TH St. NW
Red Bay, AL 35582

Mailing address

1115 4TH St. NW
P.O. Box 990
Red Bay, AL 35582
Phone (256) 356-8899

Other identifiers 1

IdentifierTypeStateIssuer
510-91868OtherALBCBS OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AL4540ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104998988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 4TH ST. NW",
            "address_2": "P.O. BOX 990",
            "city": "RED BAY",
            "state": "AL",
            "postal_code": "35582",
            "telephone_number": "256-356-8899",
            "fax_number": "256-356-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 4TH ST. NW",
            "city": "RED BAY",
            "state": "AL",
            "postal_code": "35582",
            "telephone_number": "256-356-8899",
            "fax_number": "256-356-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "STEPHEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL4540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "510-91868",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bay, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.