Individual provider Active NPI

Michael Edward Stout, DDS

  • General Practice Dentistry
  • Waynesboro, VA
National Provider Identifier
1235184995
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
VA0401007125 Issued in VA
Practice address
30 Stoneridge Drive
Suite 102
Waynesboro, VA 22980
Phone
(540) 949-8053
Fax
(540) 943-2505
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X VA0401007125 VA Primary

Addresses

Primary practice location

30 Stoneridge Drive
Suite 102
Waynesboro, VA 22980

Mailing address

30 Stoneridge Drive
Suite 102
Waynesboro, VA 22980
Phone (540) 949-8053

Other identifiers 2

IdentifierTypeStateIssuer
317947OtherVAANTHEM BCBS
7801114MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20151014002423 VA Order and Referring Only - DentistPractitioner - Dentist 2860701828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VA0401007125VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Stout DDS PC PastSince Aug 28, 2022 Accepting new patients
Michael E. Stout, DDS PC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235184995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 STONERIDGE DRIVE",
            "address_2": "SUITE 102",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "22980",
            "telephone_number": "540-949-8053",
            "fax_number": "540-943-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 STONERIDGE DRIVE",
            "address_2": "SUITE 102",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "22980",
            "telephone_number": "540-949-8053",
            "fax_number": "540-943-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "VA0401007125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "317947",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801114",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

Verify at the official NPI Registry.