Active NPI
Jeffrey Vance Stanley, D.D.S
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fresno, CA
National Provider Identifier
1194015594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 33524
- Practice address
- 6465 N Palm Ave Ste 105
Fresno, CA 93704-1085 - Phone
- (559) 435-6465
- Fax
- (559) 435-5504
- NPI assigned
- Apr 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 33524 | CA | Primary |
Addresses
Primary practice location
6465 N Palm Ave Ste 105
Fresno, CA 93704-1085
Mailing address
6465 N Palm Ave Ste 105
Fresno, CA 93704-1085
Phone (559) 435-6465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33524 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1194015594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6465 N PALM AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041085",
"telephone_number": "559-435-6465",
"fax_number": "559-435-5504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6465 N PALM AVE STE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041085",
"telephone_number": "559-435-6465",
"fax_number": "559-435-5504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "JEFFREY",
"middle_name": "VANCE",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "33524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.