Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376575076 Individual Practitioner Male Practitioner

Dr. David Wood Douglas , DDS

Dentist - General Practice • South Bend, IN

Professional Overview & Biography Verified Profile Summary

Dr. David Douglas, DDS is a registered healthcare professional specializing in Dentist - General Practice in South Bend, IN. Practice services are available at 17455 DOUGLAS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

17455 Douglas Rd
Suite 1

South Bend, IN 466351732

Telephone 5742435586
Fax 5742435587
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in South Bend, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
50 Specialists

Practicing in South Bend, IN (2204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IN 12007853

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1528127685

Doctor of Dental Surgery

Dr. Stephen Hendricks , DDS

Dentist - General Practice

NPI 1578916557

Doctor of Dental Surgery

Dr. Harvey Weingarten , DDS

Dentist - General Practice

NPI 1699841270

Doctor of Dental Surgery

Dr. Alon Shemesh , DDS

Dentist - General Practice

NPI 1760558340

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 17455 DOUGLAS RD, SUITE 1, SOUTH BEND, IN 466351732 (Tel: 5742435586)

📍
Updated Business Mailing Address July 08, 2007

Registered at 17455 DOUGLAS RD, SUITE 1, SOUTH BEND, IN 466351732 (Tel: 5742435586)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as DAVID DOUGLAS, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #12007853 in IN)

🟢
Initial NPI Registration & Enumeration July 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376575076
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

17455 Douglas Rd, Suite 1

South Bend, IN 466351732

Phone: 5742435586

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.