Macie Stultz, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7451 Issued in LA

Practice address

2935 Highway 190
Mandeville, LA 70471-3298

Phone

(985) 727-7030

NPI assigned

May 24, 2023

Sex

Female

Sole proprietor

No

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 LA

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1023700366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BETZ AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212410",
            "telephone_number": "318-527-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713298",
            "telephone_number": "985-727-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2960 Gause Blvd E",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704614153",
            "country_code": "US",
            "telephone_number": "985-641-3988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1128 Old Spanish Trl",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704585020",
            "country_code": "US",
            "telephone_number": "985-646-2146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "MACIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John F Strain, LPC
• Brian H Strand, MD
• Raven Strange, LCSW
• Angelle Stratton, DC
• Derek Stratton, DC
• Ashlyn Suchand
• Tonia Antoinette Suddeth
• Kristy Bascle Sullivan
• Summit Anesthesia, Inc.
• Superior Medical Inc.

• General Practice Dentistry in Mandeville, LA
• Providers in Mandeville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.