Individual provider Active NPI

Steven James Bumgarner, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wake Forest, NC
National Provider Identifier
1710416409
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7359 Issued in NC
Practice address
1268 S Main St
Wake Forest, NC 27587-4997
Phone
(919) 556-7820
Fax
(919) 562-5399
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 7359 NC Primary

Addresses

Primary practice location

1268 S Main St
Wake Forest, NC 27587-4997

Mailing address

1268 S Main St
Wake Forest, NC 27587-4997
Phone (919) 556-7820

Other practice location 1

1008 Big Oak Ct Ste D
Knightdale, NC 27545-6566
Phone (919) 266-6556

Other practice location 2

3600 Haworth Dr
Raleigh, NC 27609-7225
Phone (919) 782-0263

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steven J. Bumgarner, D.D.S. & James P. Martin, D.M.D., M.S., P.a. Orthodontics and Dentofacial Orthopedics PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710416409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874997",
            "telephone_number": "919-556-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874997",
            "telephone_number": "919-556-7820",
            "fax_number": "919-562-5399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Big Oak Ct Ste D",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456566",
            "country_code": "US",
            "telephone_number": "919-266-6556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Haworth Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276097225",
            "country_code": "US",
            "telephone_number": "919-782-0263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUMGARNER",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "7359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.