Individual provider Active NPI

Stephen P Dugan, DDS

  • General Practice Dentistry
  • Wichita, KS
National Provider Identifier
1215915392
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60138 Issued in KS
Practice address
7405 W Central Ave
Wichita, KS 67212
Phone
(316) 773-2244
Fax
(316) 773-2087
NPI assigned
Jan 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 60138 KS Primary

Addresses

Primary practice location

7405 W Central Ave
Wichita, KS 67212

Mailing address

7405 W Central Ave
Wichita, KS 67212
Phone (316) 773-2244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240325002038 KS Order and Referring Only - DentistPractitioner - Dentist 7618314766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dugan Family Dentistry, PA CurrentSince Jul 24, 2022 Accepting new patients

Locations

7405 W Central Ave
Wichita, KS 67212
Phone (316) 722-3191

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215915392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-773-2244",
            "fax_number": "316-773-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-773-2244",
            "fax_number": "316-773-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.