Michael Stern, D.M.D, PHD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1037 Issued in WY

Practice address

1160 Alpine LN
Suite 1D
Jackson, WY 83001

Phone

(307) 739-8611

Fax

(307) 739-8613

NPI assigned

Jan 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 5, 2015 through May 5, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Teton Oral & Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Jackson, WY
  • NPI 1164430971

  Oral and Maxillofacial Surgery

  NPD (past) Authorized official
• Teton Oral and Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Jackson, WY
  • NPI 1740776202

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1083852149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9339",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830029339",
            "telephone_number": "307-739-8611",
            "fax_number": "307-739-8613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 ALPINE LN",
            "address_2": "SUITE 1D",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-739-8611",
            "fax_number": "307-739-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WY",
            "license": "1037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119386400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St John'S Surgical Group, PC
• Samantha Stasi, MS CF-SLP
• Martha Gene Stearn, MD
• Matthew W Stech, PPC
• Elisa Stephens, NP
• Steven Nelson, PHD, Inc.
• Ashley Drummond Stewart
• Natalie Cara Stewart, RN, NBC-HWC
• James B. Stockhouse, DDS
• Stephen Stocking, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Jackson, WY
• Providers in Jackson, WY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.