Active NPI
Scott Gorden Stafford, DDS, PC
- Dentist
- Live Oak, TX
National Provider Identifier
1093004467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18592
- Legal business name
- SCOTT GORDEN STAFFORD, DDS, PC
- Practice address
- 12501 Judson Rd
Suite 101
Live Oak, TX 78233-4103 - Phone
- (210) 599-9610
- Fax
- (210) 946-8119
- NPI assigned
- Apr 6, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Scott G Stafford, DDS
- Title
- President
- Phone
- (210) 599-9610
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 18592 | TX | Primary |
Addresses
Primary practice location
12501 Judson Rd
Suite 101
Live Oak, TX 78233-4103
Mailing address
12501 Judson Rd
Suite101
Live Oak, TX 78233-4103
Phone (210) 599-9610
Other names 1
- Stafford Family Dental
National Provider Directory
National Provider Directory- Tax ID family
- Scott Gorden Stafford DDS PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Bulverde, TX
- NPI 1285842674
Locations
12501 Judson Rd
Ste 101
Live Oak, TX 78233
Phone (210) 599-9610
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- San Antonio, TX
- NPI 1629299326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1302048000000",
"number": "1093004467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12501 JUDSON RD",
"address_2": "SUITE101",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782334103",
"telephone_number": "210-599-9610",
"fax_number": "210-946-8119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12501 JUDSON RD",
"address_2": "SUITE 101",
"city": "LIVE OAK",
"state": "TX",
"postal_code": "782334103",
"telephone_number": "210-599-9610",
"fax_number": "210-946-8119"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCOTT GORDEN STAFFORD, DDS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-04-06",
"last_updated": "2011-04-06",
"status": "A",
"authorized_official_last_name": "STAFFORD",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "210-599-9610",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "TX",
"license": "18592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Stafford Family Dental",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Live Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.