Stuart R Douglas, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

029842 Issued in NY

Practice address

139 N Main St
Cortland, NY 13045

Phone

(607) 753-0602

Fax

(607) 758-8737

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stuart R Douglas DMD PLLC

  • Dentist
  • Cortland, NY
  • NPI 1407941685
  NPD (past) Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821176843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-753-0602",
            "fax_number": "607-758-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "13045",
            "telephone_number": "607-753-0602",
            "fax_number": "607-758-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "STUART",
        "middle_name": "R",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "029842",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052962",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "029842",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00562652",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Susan Dobereiner, LMFT
• Rebecca Dockstater, NP
• Teresa L Dodge, NP
• Loni Rose Donahue, P.T.A.
• Patrick M Donnelly, EDD, ATC
• Jennifer F Dovin, MSW
• Talia Cruz Dowdle, OTR/L
• Margaret A Downing, RPA
• Dr. Charlotte Hawkins
• Shannon Victoria Drake

• General Practice Dentistry in Cortland, NY
• Providers in Cortland, NY by specialty
• General Practice 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.