Individual provider Active NPI

David Martin Dugan, MD DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Oneonta, NY
National Provider Identifier
1629086582
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
219962 Issued in NY
Practice address
39 Country Club Road
Oneonta, NY 13820
Phone
(607) 432-8808
Fax
(607) 432-2307
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047041 NY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 219962 NY Primary

Addresses

Primary practice location

39 Country Club Road
Oneonta, NY 13820

Mailing address

39 Country Club Road
Oneonta, NY 13820
Phone (607) 432-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000066 NY Order and Referring Only - Maxillofacial SurgeryPractitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 7012195019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: ddugan17441@bassett.direct-ci.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A.O. Fox Memorial HospitalOneonta, NY, CCN 330085 Hospital Corporate Director (100%) Sep 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1629086582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COUNTRY CLUB ROAD",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-432-8808",
            "fax_number": "607-432-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 COUNTRY CLUB ROAD",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-432-8808",
            "fax_number": "607-432-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "DAVID",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047041",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "219962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, NY

Sources for this page

Verify at the official NPI Registry.