Carl Richard Scruggs Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

035620 Issued in NY

Practice address

37 N Main St
Massena, NY 13662-1162

Phone

(315) 769-5811

Fax

(315) 769-9236

NPI assigned

Oct 16, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386724136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 N MAIN ST",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621162",
            "telephone_number": "315-769-5811",
            "fax_number": "315-769-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 N MAIN ST",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621162",
            "telephone_number": "315-769-5811",
            "fax_number": "315-769-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "CARL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00706143",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph P Salamy, PA
• Scott Sanders, LMSW
• Sanjeev and Mukta Gupta
• Terence Duran Schumpert, MD
• Jacqueline Louise Scott-Hardy, LMSW
• Seaway Chiropractic, P.C.
• Seaway Orthopedics, PC
• Excelsa Serabian, D.D.S
• Sanjay N Shah, M.D.
• Charity Ann Shoen

• General Practice Dentistry in Massena, NY
• Providers in Massena, NY by specialty
• General Practice Dentistry in New York

• 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.