Stephen H Sutley, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

106 Issued in AK

Practice address

1275 Sadler Way
Suite 202
Fairbanks, AK 99701-3171

Phone

(907) 452-4101

Fax

(907) 452-4102

NPI assigned

Aug 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Oral Surgery

Education

Loyola University of Chicago, Stritch School of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oral Surgery Group of Frankfort, PLLCGroup PAC ID 9335327964, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oral Surgery Group of Frankfort, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Frankfort, KY
  • NPI 1568768224
  Medicare reassignment Care Compare group NPD
• Oral Surgery Group of Middletown, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Middletown, KY
  • NPI 1497070148
  Medicare reassignment NPD
• Aofs Van Leeuwen PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Fairbanks, AK
  • NPI 1831621093
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124030085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY",
            "address_2": "SUITE 202",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013171",
            "telephone_number": "907-452-4101",
            "fax_number": "907-452-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SADLER WAY",
            "address_2": "SUITE 202",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013171",
            "telephone_number": "907-452-4101",
            "fax_number": "907-452-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTLEY",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "9881",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AK",
            "license": "106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD441",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Sunnyboy
• Sunrise Counseling & Therapy Service LLP
• Surgery Center of Fairbanks LLC
• Josuhan Suriel
• Sarah Susalla
• Meghan Renne Swafford
• Laura Jean Swanson, RN
• Kimberly Sweazy, ND
• Virginia Sweetsir
• Alexandra Freund Swenson, DC

• Oral and Maxillofacial Surgery (Dentist) in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.