Active NPI
Andrea Deveau Stager
- Dentist
- Austin, TX
National Provider Identifier
1033818588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40211
- Practice address
- 8656 W US Highway 71 BLDG D
Austin, TX 78735-8196 - Phone
- (210) 617-5300
- NPI assigned
- Feb 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 40211 | TX | Primary |
Addresses
Primary practice location
8656 W US Highway 71 BLDG D
Austin, TX 78735-8196
Mailing address
8656 W US Highway 71 BLDG D
Austin, TX 78735-8196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40211 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1033818588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8656 W US HIGHWAY 71 BLDG D",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787358196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8656 W US HIGHWAY 71 BLDG D",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787358196",
"telephone_number": "210-617-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAGER",
"first_name": "ANDREA",
"middle_name": "DEVEAU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-23",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "40211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.