Nancy Jean Dougherty, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

039776 Issued in NY

Practice address

1400 Pelham Pkwy S
Acp, RM 3C15
Bronx, NY 10461-1138

Phone

(718) 918-3602

Fax

(718) 918-6147

NPI assigned

Oct 25, 2006

Last updated

Jul 8, 2007By 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 1

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

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730263534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "APT. 5L",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246036",
            "telephone_number": "718-918-3602",
            "fax_number": "718-918-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "address_2": "ACP, RM 3C15",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-3602",
            "fax_number": "718-918-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "039776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Double Y Ambulette Corp.
• Adria Lee Doubleday-Stern, PSY.D.
• Caren Doueiry
• Sandria Dougall
• Caroline Dougherty
• Serniqua Dougherty
• Douglas Bennet Herzlich DPM PC
• Alexandra Welch Douglas, MD-MPH
• Alina Douglas
• Andrew Walter Douglas, RPA-C

• Pediatric Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• Pediatric Dentistry in New York

• 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.
• 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.