NPIMap

Organization Active NPI

Stuckey & Mudd DDS

  • Dental Clinic/Center
  • Charlotte, NC
National Provider Identifier
1992976559
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
NC5980 Issued in NC
Legal business name
STUCKEY & MUDD DDS
Practice address
6865 Fairview Rd
Suite a
Charlotte, NC 28210-2700
Phone
(704) 364-9686
NPI assigned
Mar 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Authorized official

Name
Dr. Douglas Stuckey, DDSNPI 1376592709
Title
General Partner
Phone
(704) 364-9686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NC5980 NC Primary
Dental Clinic/Center 261QD0000X NC 7310 NC

Addresses

Primary practice location

6865 Fairview Rd
Suite a
Charlotte, NC 28210-2700

Mailing address

6865 Fairview Rd
Suite a
Charlotte, NC 28210-2700
Phone (704) 364-9686

Other names 1

  • SouthPark Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

6865 Fairview Rd
Ste A
Charlotte, NC 28210
Phone (704) 364-9686

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206057600000",
    "number": "1992976559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 FAIRVIEW RD",
            "address_2": "SUITE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102700",
            "telephone_number": "704-364-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 FAIRVIEW RD",
            "address_2": "SUITE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102700",
            "telephone_number": "704-364-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUCKEY & MUDD DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A",
        "authorized_official_last_name": "STUCKEY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "704-364-9686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "NC5980",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "NC 7310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthPark Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.