Patricia Adeleke Stainback, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6637 Issued in NC

Practice address

798 Church St N
Concord, NC 28025-4368

Phone

(704) 720-0692

Fax

(704) 720-0693

NPI assigned

Apr 26, 2007

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

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.

• Patricia a. Stainback, D.M.D., P.a.

  • General Practice Dentistry
  • Concord, NC
  • NPI 1083834840
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1124248786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254368",
            "telephone_number": "704-720-0692",
            "fax_number": "704-720-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254368",
            "telephone_number": "704-720-0692",
            "fax_number": "704-720-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAINBACK",
        "first_name": "PATRICIA",
        "middle_name": "ADELEKE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899001V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Concord, NC
• Providers in Concord, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.