Myra M Stafford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3788 Issued in AL

Practice address

300 North Airport Road
Jasper, AL 35504-3850

Phone

(205) 221-6700

Fax

(205) 221-9194

NPI assigned

Jul 22, 2006

Sex

Female

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

Enrolled in AL

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

Locations

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.

• Stafford Dental PC

  • Dentist
  • Jasper, AL
  • NPI 1023947322
  NPD Authorized official
• Stafford Dental PC

  • General Practice Dentistry
  • Jasper, AL
  • NPI 1457732588
  NPD (past) Authorized official

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255352233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NORTH AIRPORT ROAD",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355043850",
            "telephone_number": "205-221-6700",
            "fax_number": "205-221-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH AIRPORT ROAD",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355043850",
            "telephone_number": "205-221-6700",
            "fax_number": "205-221-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "MYRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51552873",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "139050",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southerncare, Inc
• Nathanael Robert Sparkman, DPT
• Speech Works of Alabama, LLC
• Stafford Dental PC
• Stafford Dental PC
• Nellie Stallsmith
• State of Alabama
• State of Alabama Department of Public Health
• State of Alabama Department of Public Health
• Stephanie Steiner

• General Practice Dentistry in Jasper, AL
• Providers in Jasper, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.