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DAVID WOOD DOUGLAS D.D.S.
NPI 1376575076
Dentist - General Practice in South Bend, IN

Active since July 06, 2006PECOS Enrolled
17455 DOUGLAS RD, SUITE 1, SOUTH BEND, IN 46635(574) 243-5586(574) 243-5587 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About David Wood Douglas D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID WOOD DOUGLAS D.D.S. (NPI 1376575076) is an individual general practice provider in South Bend, Indiana, licensed in Indiana (12007853) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376575076
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDAVID WOOD DOUGLASCredential: D.D.S.
Location Address17455 DOUGLAS RD, SUITE 1South Bend, IN 46635-1732
Mailing Address17455 Douglas Rd, Suite 1South Bend, IN 46635-1732 · (574) 243-5586 · Fax (574) 243-5587
Phone(574) 243-5586
Fax(574) 243-5587
Sole ProprietorYes
Enumeration DateJuly 6, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376575076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IN · 12007853
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
17455 DOUGLAS RD, South Bend, IN 46635
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David Wood Douglas D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46635 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN HENDRICKS D.D.S.
Dentist (General Practice)
17455 DOUGLAS RD
SOUTH BEND, IN 46635
St. Joseph County (574) 243-5586
FAMILY DENTAL HEALTH CORPORATION
Dentist (General Practice)
17455 DOUGLAS RD
SOUTH BEND, IN 46635
St. Joseph County (574) 243-5586
DR. LYDIA A LORENC DMD
Dentist (General Practice)
17455 DOUGLAS RD
SOUTH BEND, IN 46635
St. Joseph County (574) 243-5584
DR. HARVEY WEINGARTEN DDS
Dentist (General Practice)
17455 DOUGLAS RD
SOUTH BEND, IN 46635
St. Joseph County (574) 243-5586
ALON SHEMESH DDS
Dentist (General Practice)
17455 DOUGLAS RD
SOUTH BEND, IN 46635
St. Joseph County (574) 243-5586

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Douglas's NPI number?

The NPI number for David Douglas is 1376575076. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is David Douglas located?

David Douglas practices at 17455 Douglas Rd Suite 1, South Bend, IN 46635. The listed phone number is (574) 243-5586.

What is David Douglas's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is David Douglas enrolled in Medicare?

Yes. David Douglas is registered in the Medicare PECOS enrollment system.

What insurance does David Douglas accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list David Douglas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for David Douglas was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.