Active NPI
Caitlyn Stouder Long, DMD
- Dentist
- Buford, GA
National Provider Identifier
1821624347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN016060
- Practice address
- 2333 Sparta Way
Buford, GA 30519-2000 - Phone
- (770) 637-1873
- NPI assigned
- Mar 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN016060 | GA | Primary |
Addresses
Primary practice location
2333 Sparta Way
Buford, GA 30519-2000
Mailing address
2333 Sparta Way
Buford, GA 30519-2000
Other practice location 1
4393 Fernbrook Xing
Evans, GA 30809-4602
Phone (706) 836-5217
Other practice location 2
655 South 7th Street BLDG 700/700-A
78 MDG/SGXD
Robins AFB, GA 31098-2227
Phone (478) 327-4431
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cstouder@augusta.edu | Direct | Augusta University |
| Direct Messaging Address | cstouder@augusta.edu | Direct | Augusta University |
| Direct Messaging Address | cailong@augusta.edu | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN016060 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1821624347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2333 SPARTA WAY",
"city": "BUFORD",
"state": "GA",
"postal_code": "305192000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2333 SPARTA WAY",
"city": "BUFORD",
"state": "GA",
"postal_code": "305192000",
"telephone_number": "770-637-1873"
}
],
"practiceLocations": [
{
"address_1": "4393 Fernbrook Xing",
"address_purpose": "LOCATION",
"city": "Evans",
"state": "GA",
"postal_code": "308094602",
"country_code": "US",
"telephone_number": "706-836-5217",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "655 South 7th Street BLDG 700/700-A",
"address_2": "78 MDG/SGXD",
"address_purpose": "LOCATION",
"city": "Robins AFB",
"state": "GA",
"postal_code": "310982227",
"country_code": "US",
"telephone_number": "478-327-4431",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LONG",
"first_name": "CAITLYN",
"middle_name": "STOUDER",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN016060",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cstouder@augusta.edu",
"affiliation": "Y",
"endpointDescription": "School Email",
"affiliationName": "Augusta University",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "unknown",
"address_1": "1430 John Wesley Gilbert Dr",
"city": "Augusta",
"state": "GA",
"country_code": "US",
"postal_code": "30901",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cstouder@augusta.edu",
"affiliation": "Y",
"endpointDescription": "School Email",
"affiliationName": "Augusta University",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "unknown",
"address_1": "1430 John Wesley Gilbert Dr",
"city": "Augusta",
"state": "GA",
"country_code": "US",
"postal_code": "30901",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cailong@augusta.edu",
"affiliation": "N",
"endpointDescription": "School Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "unknown",
"address_1": "5305 Honeysuckle Ln",
"city": "Bossier City",
"state": "LA",
"country_code": "US",
"postal_code": "711124978",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.