Richard A Stimson, DDS
Individual provider Active NPI Dentist · Teecnospos, AZ
NPI 1205948890 · NPPES record last updated Feb 19, 2008
Key facts
- NPI
- 1205948890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1081 (NM)
- Practice address
- JCT US Hwy 160 & Navajo Route 35 Red Mesa
Teecnospos, AZ 86514 - Phone
- (928) 656-5000
- Fax
- (928) 545-5164
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1081 | NM | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1081 | NM | Yes |
Addresses
Primary practice location
JCT US Hwy 160 & Navajo Route 35 Red Mesa
Teecnospos, AZ 86514
Mailing address
HCR 6100 Box 30
Teecnospos, AZ 86514
Phone (928) 656-5000
Other providers in Teecnospos, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.