Beatrice Ann Stark, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3585 Issued in NV

Practice address

8551 W Lake Mead Blvd
#260
Las Vegas, NV 89128-7642

Phone

(702) 437-1007

Fax

(702) 304-1126

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1013015239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 W LAKE MEAD BLVD",
            "address_2": "#260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287642",
            "telephone_number": "702-437-1007",
            "fax_number": "702-304-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8551 W LAKE MEAD BLVD",
            "address_2": "#260",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287642",
            "telephone_number": "702-437-1007",
            "fax_number": "702-304-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BEATRICE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Starfruit Holdings, LLC
• Stark Industries Medical
• Stark Medicine
• Stark Medicine McKay Khurana Jeider PLLC
• Stark Medicine McKay Khurana Jeider PLLC
• Brian William Stark Jr., PA-C
• Ellen Stark, LSW
• Keith A Stark
• Renee Stark
• Vlada Stark

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.