Candace Rebecca Scruggs, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

055584 Issued in NY

Practice address

5109 W Genesee St Ste 101
Camillus, NY 13031-2372

Phone

(315) 487-2668

Fax

(315) 487-8661

NPI assigned

Jul 3, 2007

Last updated

Mar 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vitkus, Scutari & Cardoso Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fayetteville, NY
  • NPI 1275618019
  NPD

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1679771547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MEDICAL CENTER DRIVE",
            "address_2": "SUITE B13",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "13066",
            "telephone_number": "315-637-4476",
            "fax_number": "315-637-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 W GENESEE ST STE 101",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312372",
            "telephone_number": "315-487-2668",
            "fax_number": "315-487-8661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Medical Center Drive",
            "address_2": "Suite B13",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NY",
            "postal_code": "13066",
            "country_code": "US",
            "telephone_number": "315-637-4476",
            "fax_number": "315-637-1261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCRUGGS",
        "first_name": "CANDACE",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4347",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "055584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Marie Schonewald, PA
• Alanna Rose Schoonmaker, M.S. CCC-SLP
• Michael Kenneth Schrank, LMSW
• Vincent Nicholas Scialdone, MD
• Michelle Scott, LCSW-R
• Matia Senyonga, PHARM.D
• Nicholas Shashati, OD
• Nicole Sigg, PHARMD.,RPH
• Matthew David Silvaggio, MSPT
• Karen Simbari, F.N.P.

• Oral and Maxillofacial Surgery (Dentist) in Camillus, NY
• Providers in Camillus, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.