Individual provider Active NPI

Elizabeth Ellen Duling, DMD

  • Dentist
  • Ft. Drum, NY
National Provider Identifier
1992796981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052217-1 Issued in NY
Practice address
10205 N. Riva Ridge Loop
U.S. Army Dental Activity Attn: Credentials
Ft. Drum, NY 13602-5005
Phone
(315) 772-4342
Fax
(315) 772-9692
NPI assigned
Oct 31, 2005
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 052217-1 NY Primary

Addresses

Primary practice location

10205 N. Riva Ridge Loop
U.S. Army Dental Activity Attn: Credentials
Ft. Drum, NY 13602-5005

Mailing address

10205 N. Riva Ridge Loop
U.S. Army Dental Activity Attn: Credentials
Ft. Drum, NY 13602-5005
Phone (315) 772-4342

Other names 1

  • Dr. Elizabeth Ellen Scala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20160113000293 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860794567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052217-1NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cove Family Dentistry, LLC CurrentSince Jun 28, 2017 Accepting new patients

Locations

6707 Highway 431 S
Ste 103
Owens Cross Roads, AL 35763
Phone (256) 534-1475

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992796981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10205 N. RIVA RIDGE LOOP",
            "address_2": "U.S. ARMY DENTAL ACTIVITY ATTN: CREDENTIALS",
            "city": "FT. DRUM",
            "state": "NY",
            "postal_code": "136025005",
            "telephone_number": "315-772-4342",
            "fax_number": "315-772-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10205 N. RIVA RIDGE LOOP",
            "address_2": "U.S. ARMY DENTAL ACTIVITY ATTN: CREDENTIALS",
            "city": "FT. DRUM",
            "state": "NY",
            "postal_code": "136025005",
            "telephone_number": "315-772-4342",
            "fax_number": "315-772-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULING",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052217-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SCALA",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ft. Drum, NY

Sources for this page

Verify at the official NPI Registry.