Robert H Stark Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00004004 Issued in WA

Practice address

4530 Union Bay PL NE Ste 206
Seattle, WA 98105-4000

Phone

(206) 525-5000

Fax

(206) 523-3077

NPI assigned

Mar 29, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225158975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 UNION BAY PL NE STE 206",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054000",
            "telephone_number": "206-525-5000",
            "fax_number": "206-523-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 UNION BAY PL NE STE 206",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054000",
            "telephone_number": "206-525-5000",
            "fax_number": "206-523-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00004004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5037387",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "153606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cain William Stark, MD
• Katarina Josephine Stark, MD
• Lauren Stark, RD
• Mikayla Stark, LSWAIC
• Nathan Charles Stark, L.M.P
• Gordon Alan Starkebaum, MD
• Mary Kathryn Starkebaum, M.D.
• Julie Linn Starkel, M.S., M.B.A., R.D.,
• Elizabeth A Starkey, MS
• Devon Marie Starkovich, PA-C

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.