Individual provider Active NPI

Douglas Mayovane Vargas, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1548244106
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0502071 Issued in NY
Practice address
713 Saint Nicholas Ave
Ground FL
New York, NY 10031-4905
Phone
(212) 234-6960
Fax
(212) 234-6982
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0502071 NY Primary

Addresses

Primary practice location

713 Saint Nicholas Ave
Ground FL
New York, NY 10031-4905

Mailing address

984 Sheridan Ave
Apt 3a
Bronx, NY 10456-6330

Other identifiers 1

IdentifierTypeStateIssuer
02395471MedicaidNY

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

LicenseStateTypeSpecialty
0502071NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1548244106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 SHERIDAN AVE",
            "address_2": "APT 3A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104566330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 SAINT NICHOLAS AVE",
            "address_2": "GROUND FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100314905",
            "telephone_number": "212-234-6960",
            "fax_number": "212-234-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "DOUGLAS",
        "middle_name": "MAYOVANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0502071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02395471",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.