Alfred Kenneth Stockin, DDS DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4153 Issued in NC

Practice address

3535 Randolph Road
Suite 200 Randolph Medical Park
Charlotte, NC 28211

Phone

(704) 364-1191

Fax

(704) 364-1185

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Ken Stockin Other name

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003907288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 RANDOLPH ROAD",
            "address_2": "SUITE 200 RANDOLPH MEDICAL PARK",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-364-1191",
            "fax_number": "704-364-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 RANDOLPH ROAD",
            "address_2": "SUITE 200 RANDOLPH MEDICAL PARK",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-364-1191",
            "fax_number": "704-364-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKIN",
        "first_name": "ALFRED",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DDS DENTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4153",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 6511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEN",
            "last_name": "STOCKIN",
            "prefix": "DR.",
            "credential": "DDS DENTIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Nathan Stipec
• Shelly Stith
• Kristi Stitt
• Naqualya Stitt
• Stmichaels Healthcare Services
• Rebekah Anne Stockstill, PA-C
• Kelsey Stocum
• Laura M Stoddard, MD
• Elisabeth Anne Stoffel, MD
• Bobbie C Stokes, MSHE

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.