Individual provider Active NPI

Cheryl Ann Doumar, DMD

  • Dentist
  • Ridgefield, CT
National Provider Identifier
1902015571
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6014 Issued in CT
Practice address
63 Copps Hill Rd
Ridgefield, CT 06877-4050
Phone
(203) 431-4344
Fax
(203) 431-3236
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6014 CT Primary

Addresses

Primary practice location

63 Copps Hill Rd
Ridgefield, CT 06877-4050

Mailing address

63 Copps Hill Rd
Ridgefield, CT 06877-4050
Phone (203) 431-4344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20150313001165 CT Order and Referring Only - DentistPractitioner - Dentist 1951627702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902015571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 COPPS HILL RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774050",
            "telephone_number": "203-431-4344",
            "fax_number": "203-431-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 COPPS HILL RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774050",
            "telephone_number": "203-431-4344",
            "fax_number": "203-431-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUMAR",
        "first_name": "CHERYL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "6014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

Verify at the official NPI Registry.