Carol Stockhausen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60679859 Issued in WA

Practice address

1301 N Ephrata Ave
Connell, WA 99326-9601

Phone

(509) 543-5800

NPI assigned

Sep 19, 2016

Last updated

Sep 19, 2016By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Washington State Department of Corrections Coyote Ridge Corrections Ce

  • Prison Health Clinic/Center
  • Connell, WA
  • NPI 1629369095
  NPD (past)

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1124576129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GAGE BLVD APT A-2001",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N EPHRATA AVE",
            "city": "CONNELL",
            "state": "WA",
            "postal_code": "993269601",
            "telephone_number": "509-543-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKHAUSEN",
        "first_name": "CAROL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60679859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Francis Quiggle, LMHC
• Ahmed Bashir Raddad
• Shane Ririe, PA-C
• Kiley Sauder
• Lois Eileen Smith, CDP
• Jonathan Jay Walker, O.D.
• Brandon R Walters, O.D.
• Washington State Department of Corrections Coyote Ridge Corrections Ce

• Dentist in Connell, WA
• Providers in Connell, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.