Jean M Stolt, RDH

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2901018239 Issued in MI

Practice address

3434 M 119 Ste G
Harbor Springs, MI 49740-9373

Phone

(231) 348-3970

Fax

(231) 348-3946

NPI assigned

Nov 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1063058097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 M 119 STE G",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-3970",
            "fax_number": "231-348-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 M 119 STE G",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-3970",
            "fax_number": "231-348-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLT",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902012500",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "2901018239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2902012500",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Interoffice",
            "affiliation": "N",
            "endpointDescription": "Dental Clinics North Organization",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3434 M 119 Ste G",
            "city": "Harbor Springs",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497409373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Interoffice",
            "affiliation": "N",
            "endpointDescription": "Dental Clinics North Organization",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3434 M 119 Ste G",
            "city": "Harbor Springs",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497409373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marty P Sheridan-Parks, PTA
• Lauren Smith, LMSW
• Shannon Gabrielle Snider, PA-C
• Joseph Sobota, M. D.
• William Joel Steinbach, D.C.
• Rene Rochelle Straub, NP-C
• Kerby M Tamm, DPT
• John Matthew Thorp, LMSW
• Timothy I Bondy Inc
• Jennifer Tunison

• Public Health Dentistry in Harbor Springs, MI
• Providers in Harbor Springs, MI by specialty
• Public Health Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.