DR. FRED SHAKESPEARE FERGUSON (NPI# 1194856872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194856872 |
| Entity Type | Individual |
| Full Name | DR. FRED SHAKESPEARE FERGUSON |
| Credential | DDS |
| Practice Address |
Stony Brook Dental Associates Sullivan Hall Rm 170 Stony Brook NY 11794-0001 |
| Mailing Address |
10 Braemer Rd Setauket NY 11733-3905 |
| Practice Telephone | 6316328971 |
| Mailing Telephone | 6317513901 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
031804 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00675654 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093775587 | Fred B Ferguson | Specialist | 102 Us Highway 321 Byp N, Winnsboro, SC 29180-9251 | 2006-03-27 |
| Street Address |
STONY BROOK DENTAL ASSOCIATES SULLIVAN HALL RM 170 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841253788 | Denise Amanda Trochesset | Dentist | Stony Brook Dental Associates, Sullivan Hall, Room 170, Stony Brook, NY 11794-8705 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912153461 | Rhona Strizak-sherwin | Dentist | Stony Brook Schl of Dental Medicine, Stony Brook, NY 11794-0001 | 2008-08-15 |
| 1265602874 | Stony Brook Dental Associates | Dentist | Sullivan Hall Room 170, Faculty Practice, Stony Brook, NY 11794-8705 | 2008-03-11 |
| 1972922599 | Matthew Neill Zimmer | Dentist | 100 Nicolls Rd, 114 Rockland Hall, Stony Brook, NY 11794 | 2014-04-10 |
| 1942543210 | Dr. Chris' Small Smiles Pediatric Dentistry | Dentist | 215 Hallock Rd, Suite 2, Stony Brook, NY 11790-3078 | 2013-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557059 | Smiles and Grins Pediatric Dentistry | Dentist | 160 E 88th St Apt 1d, New York, NY 10128-2217 | 2020-10-30 |
| 1891395810 | Ez Orthodontics Pllc | Dentist | 4010 82nd St Fl 2, Elmhurst, NY 11373-1305 | 2020-10-28 |
| 1346858677 | Kids Dental of Queens PC | Dentist | 4236 82nd St # C, Elmhurst, NY 11373-3537 | 2020-07-22 |
| 1073131512 | Prohealth Dental Pllc | Dentist | 2318 31st St Ste 320, Astoria, NY 11105-2765 | 2020-07-10 |
| 1952929911 | Kiddsmiles Pediatric Dentistry 7 Pllc | Dentist | 263 Jericho Tpke, Floral Park, NY 11001-2146 | 2020-07-07 |
| 1376177782 | Pco Ortho LLC | Dentist | 3422 35th St, Long Island City, NY 11106-1268 | 2020-02-24 |
| 1033749916 | Yehuda Marciano Dds PC | Dentist | 932 Broadway Ste 1, Woodmere, NY 11598-1723 | 2020-01-20 |
| 1710521752 | Asnis Dental Pllc | Dentist | 800 N Broadway, Massapequa, NY 11758-2335 | 2019-11-02 |
| 1760026777 | Dr. Stephen A Festa-pediatric Dentistry Pllc | Dentist | 3755 76th St Bsmt Apt, Jackson Heights, NY 11372-6552 | 2019-11-01 |
| 1841849965 | Woodrow Little Smiles Family Dentistry P.C. | Dentist | 739 Woodrow Road, Staten Island, NY 10312 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.