Seth Stacey, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

103955 Issued in CA

Practice address

1620 E 2ND St Ste a
Beaumont, CA 92223-3171

Phone

(951) 769-9131

NPI assigned

Jul 10, 2019

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moore Dental Corporation

  • General Practice Dentistry
  • Beaumont, CA
  • NPI 1174774699
  NPD (past)
• Lafayette Modern Smiles Dentistry and Orthodontics, LLP

  • General Practice Dentistry
  • Lafayette, CO
  • NPI 1730437807
  NPD (past)

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1043862006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ORANGE AVE APT 301",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731493",
            "telephone_number": "970-215-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 2ND ST STE A",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233171",
            "telephone_number": "951-769-9131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1217 Diamond Cir Unit 1",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800269330",
            "country_code": "US",
            "telephone_number": "303-449-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACEY",
        "first_name": "SETH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205527",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Smart, LCSW
• Savanna Lynne Smith, M.S., CCC-SLP
• Bailey Daniele Solis
• Jeanine Jugo Soriano
• Lowell L Sparks Jr., MD
• Danece R. Stapleton, LCSW
• Justin Stevenson, CRNA
• Leah S Stewart
• Camille Marie Stone, CNM
• Mukunthan Subramani

• Dentist in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.