Mitchell R Stumpf, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

2010022943 Issued in MO

Practice address

13035 Olive Blvd
Suite #214
Creve Coeur, MO 63141-6173

Phone

(314) 205-0111

NPI assigned

Aug 5, 2010

Sex

Male

Sole proprietor

Yes

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

Enrolled in MO

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

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1144534868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 MISTY MOSS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464210",
            "telephone_number": "618-978-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 OLIVE BLVD",
            "address_2": "SUITE #214",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416173",
            "telephone_number": "314-205-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMPF",
        "first_name": "MITCHELL",
        "middle_name": "R",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010022943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis K Stovall, D.M.D.
• Kelsey Straatmann, MA
• Kimberly Sue Streff, MS, CCC-SLP,BCBA,LBA
• Shelley Stretch, LPC
• Brent V Stromberg, MD
• Suburban Foot Care
• Thomas Evan Suddeth
• Allyson Suiter
• Hailey Jo Sullivan
• Sunshine Healthcare, LLC

• All providers in Creve Coeur, MO
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.