Ronald Stangebye, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009268 Issued in IN

Practice address

1005 E Lasalle Ave
South Bend, IN 46617-2818

Phone

(574) 245-7503

Fax

(547) 245-7502

NPI assigned

Jul 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

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.

• The Dental Center of South Bend LLC

  • Pediatric Dentistry
  • South Bend, IN
  • NPI 1538184460
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144243932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "547-245-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E LASALLE AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172818",
            "telephone_number": "574-245-7503",
            "fax_number": "547-245-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGEBYE",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LISCENSE",
            "identifier": "12009268A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Stahl, FNP-BC
• Madelyn Stahl, RPH
• Alec Thomas Staiger, DO
• Alyssa Stair, RBT
• Peri R Stangas, PA-C
• Cynthia Danielle Stanton
• Catherine Stapleford, MSED
• Star Psychiatric Services PC
• Star Psychiatric Services PC
• Michael J Star

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.