Stuart W Allyn, DDS, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

144637 Issued in MT

Practice address

805 S Reserve St, Missoula, Mt
Missoula, MT 59801

Phone

(406) 549-6600

NPI assigned

Mar 15, 2018

Last updated

Oct 15, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 12, 2025 through Feb 12, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1073016028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S RESERVE ST, MISSOULA, MT 59801",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S RESERVE ST, MISSOULA, MT",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801",
            "telephone_number": "406-549-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLYN",
        "first_name": "STUART",
        "middle_name": "W",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MT",
            "license": "DEN-DEN-LIC-28338",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MT",
            "license": "144637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Surgery Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.