Warren Frederick Daugherty Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D5015609L Issued in PA

Practice address

207 Hathaway Park
Lebanon, PA 17042-6163

Phone

(717) 273-0411

Fax

(717) 272-7099

NPI assigned

Sep 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lebanon Family Dental

  • Dentist
  • Lebanon, PA
  • NPI 1417252206
  NPD (past)
• Pottsville Family Dental

  • Dentist
  • Pottsville, PA
  • NPI 1902102965
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245332394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HATHAWAY PARK",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426163",
            "telephone_number": "717-273-0411",
            "fax_number": "717-272-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HATHAWAY PARK",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426163",
            "telephone_number": "717-273-0411",
            "fax_number": "717-272-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "WARREN",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "D5015609L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MET LIFE",
            "identifier": "1156932",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "59606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne V Dall
• Olivia Ann Dalton, LPC
• Casey Dando
• Daniel & Max, LLC
• Kelsey Daubert, MA, LPC
• Warren Patrick Daugherty, DMD
• David L Streisfeld MD PC (Clearview Optical)
• David L. Streisfeld, M.D., P.C.
• Bradley Kenneth Davidson, M.D.
• Dawn Audrey Davies, B.A.

• Dentist in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.