Douglas Fujawa, DDS, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN23156 Issued in FL

Practice address

3123 W 23Rd St
Panama City, FL 32405-1828

Phone

(850) 481-1969

NPI assigned

Sep 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1336541135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324051828",
            "telephone_number": "850-481-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324051828",
            "telephone_number": "850-481-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJAWA",
        "first_name": "DOUGLAS",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021229",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN23156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023778300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claude Randall Fridley
• Christine A Frohlich, CRNA
• Stephanie Rae Frost
• Justin Frye
• FSL-Panama City, LLC (St. Andrew Health and Rehabilitaion Center)
• Paula Conette Fulford, ARNP
• Michael Paul Fulghum, RPH
• Stacia Fulmer-Britt, MSCP
• Jessica Katherine Fuqua, PA-C
• Morgan Shaye Fusco, APRN

• Pediatric Dentistry in Panama City, FL
• Providers in Panama City, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.