Douglas A Stanley, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008864 Issued in IN

Practice address

1213 W Lincoln Ave
Goshen, IN 46526-2130

Phone

(574) 533-6911

Fax

(574) 534-4672

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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 IN

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

Practice roles

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.

• Deana Fugate DMD PC

  • Dental Clinic/Center
  • Goshen, IN
  • NPI 1710638358
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801978127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262130",
            "telephone_number": "574-533-6911",
            "fax_number": "574-534-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465262130",
            "telephone_number": "574-533-6911",
            "fax_number": "574-534-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Springer, FNP-C
• Jennifer R Stabler, OTR
• Jill Stahly, LSW
• Katherine Staltari
• Billie Stamp, NP-C
• Mykenzie Stanley
• Rachael Stark, BCBA
• Michelle Stearns
• Catherine Ann Steinkamp, NP
• Stephen Szynal DO

• General Practice Dentistry in Goshen, IN
• Providers in Goshen, IN by specialty
• General Practice Dentistry in Indiana

• 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.