Stan M Udouj, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2725 Issued in AR

Practice address

520 S 14TH St
Fort Smith, AR 72901-4608

Phone

(479) 782-3005

Fax

(479) 494-7490

NPI assigned

Jul 13, 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

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

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.

• Regional Dental Center Inc

  • General Practice Dentistry
  • Fort Smith, AR
  • NPI 1396958880
  Authorized official Same address or phone

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457376246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 14TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014608",
            "telephone_number": "479-782-3005",
            "fax_number": "479-494-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 14TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729014608",
            "telephone_number": "479-782-3005",
            "fax_number": "479-494-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOUJ",
        "first_name": "STAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie N Tyson, RN
• Uams (Family Medical Center AHEC)
• Uams Family Medical Center Facility
• Henry Joseph Udouj III, D.D.S.
• John C. Udouj, D.M.D.
• Judith Nneka Ugwu Erugo, MD
• Ndidibuike N Ukwe, MD
• Nuttha Ungnapatanin, M.D.
• Union Medical Supply,LLC
• Uniquely Integrated Counseling and Consulting LLC

• General Practice Dentistry in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• General Practice Dentistry in Arkansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.