Active NPI
Gary R Sugg, DDS MS
- Endodontics
- Charlotte, NC
National Provider Identifier
1699787333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 120
- Practice address
- 4525 Park Road
Ste B104
Charlotte, NC 28209-3723 - Phone
- (704) 527-4895
- Fax
- (704) 527-1407
- NPI assigned
- Aug 12, 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 120 | NC | Primary |
Addresses
Primary practice location
4525 Park Road
Ste B104
Charlotte, NC 28209-3723
Mailing address
4525 Park Road
Ste B104
Charlotte, NC 28209-3723
Phone (704) 527-4895
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8998197 | Medicaid | NC | |
| 98197 | Other | NC | BCBS 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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699787333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 PARK ROAD",
"address_2": "STE B104",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093723",
"telephone_number": "704-527-4895",
"fax_number": "704-527-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4525 PARK ROAD",
"address_2": "STE B104",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093723",
"telephone_number": "704-527-4895",
"fax_number": "704-527-1407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUGG",
"first_name": "GARY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NC",
"license": "120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8998197",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "98197",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, 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.