Stacy Nicole Tarleton, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

8240 Issued in MD

Practice address

572 Ritchie Hwy Ste F
Severna Park, MD 21146-2966

Phone

(410) 647-4094

NPI assigned

Sep 25, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacy Nicole Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Maryland Dental Healthcare Network, LLC

  • Dentist
  • Annapolis, MD
  • NPI 1841039070
  NPD
• Yeremi a Canizales DDS P a

  • General Practice Dentistry
  • Severna Park, MD
  • NPI 1275902298

  Dental Hygienist

  NPD

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1154100725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 WASHINGTON BLVD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613883",
            "telephone_number": "410-608-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 RITCHIE HWY STE F",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462966",
            "telephone_number": "410-647-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARLETON",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MD",
            "license": "8240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "LEE",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dental Hygienist in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Dental Hygienist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.