Active NPI
Dana S Scheetz, DDS
- General Practice Dentistry
- Jacksonville, NC
National Provider Identifier
1487751905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4807
- Practice address
- 200 Doctors Drive
Suite F
Jacksonville, NC 28546 - Phone
- (910) 353-4242
- Fax
- (910) 577-6421
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4807 | OH | Primary |
Addresses
Primary practice location
200 Doctors Drive
Suite F
Jacksonville, NC 28546
Mailing address
200 Doctors Drive
Suite F
Jacksonville, NC 28546
Phone (910) 353-4242
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02211 | Other | NC | BCBS |
| 2996 | Other | NC | DELTA |
| 8990244 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4807 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson and Slack PA | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Jacksonville, NC
- NPI 1508976440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487751905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 DOCTORS DRIVE",
"address_2": "SUITE F",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-353-4242",
"fax_number": "910-577-6421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 DOCTORS DRIVE",
"address_2": "SUITE F",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "28546",
"telephone_number": "910-353-4242",
"fax_number": "910-577-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHEETZ",
"first_name": "DANA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "4807",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02211",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA",
"identifier": "2996",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8990244",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- 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.