Individual provider Active NPI

Stephen M Dargan, D.D.S,P.A

  • General Practice Dentistry
  • Prince Frederick, MD
National Provider Identifier
1538164900
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6397 Issued in MD
Practice address
55 Stoakley Rd
Prince Frederick, MD 20678-3859
Phone
(410) 535-4050
Fax
(410) 535-0932
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6397 MD Primary

Addresses

Primary practice location

55 Stoakley Rd
Prince Frederick, MD 20678-3859

Mailing address

55 Stoakley Rd
Prince Frederick, MD 20678-3859
Phone (410) 535-4050

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6397MDMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1538164900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 STOAKLEY RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783859",
            "telephone_number": "410-535-4050",
            "fax_number": "410-535-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 STOAKLEY RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783859",
            "telephone_number": "410-535-4050",
            "fax_number": "410-535-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARGAN",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S,P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.