Lola Stanson, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

63804 Issued in CA

Practice address

1661 Soquel Dr Ste a
Santa Cruz, CA 95065-1709

Phone

(831) 476-5512

NPI assigned

Aug 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Santa Cruz Children'S Dental Group

  • Pediatric Dentistry
  • Santa Cruz, CA
  • NPI 1245533538
  NPD (past)

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1235548843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 CAPTAINS CT",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 SOQUEL DR STE A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651709",
            "telephone_number": "831-476-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSON",
        "first_name": "LOLA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "63804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Stamp, PHARM D
• Palmer Wendell Stamps
• Charles Ian Stange
• Stanislaus County
• Frederick S Stanley III
• Jerri S Stanton, RN
• Morning Star, L.AC.
• Rachel Dale Star, PPSC
• Ashley Stauffacher, LCSW
• Ricki Lee Stautz, MSW

• Pediatric Dentistry in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.