Individual provider Active NPI

Robert John Stasny, DDS

  • General Practice Dentistry
  • Flower Mound, TX
National Provider Identifier
1083628655
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TX 18898 Issued in TX
Practice address
6101 Long Prairie Rd Ste 752
Flower Mound, TX 75028-6207
Phone
(972) 691-0885
Fax
(972) 691-0880
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X TX 18898 TX Primary

Addresses

Primary practice location

6101 Long Prairie Rd Ste 752
Flower Mound, TX 75028-6207

Mailing address

6101 Long Prairie Rd Ste 752
Flower Mound, TX 75028-6207
Phone (972) 691-0885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160111001851 TX Order and Referring Only - DentistPractitioner - Dentist 1355643115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX 18898TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1083628655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 LONG PRAIRIE RD STE 752",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750286207",
            "telephone_number": "972-691-0885",
            "fax_number": "972-691-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 LONG PRAIRIE RD STE 752",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750286207",
            "telephone_number": "972-691-0885",
            "fax_number": "972-691-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASNY",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "TX 18898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.