Individual provider Active NPI

Ronald Paul Stifter, DDS

  • Dentist
  • Saukville, WI
National Provider Identifier
1275649790
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5000468015 Issued in WI
Practice address
2659 Hawthorne Dr
Saukville, WI 53080-1109
Phone
(262) 675-6065
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5000468015 WI Primary

Addresses

Primary practice location

2659 Hawthorne Dr
Saukville, WI 53080-1109

Mailing address

2659 Hawthorne Dr
Saukville, WI 53080-1109
Phone (262) 675-6065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5000468015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1275649790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 HAWTHORNE DR",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530801109",
            "telephone_number": "262-675-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 HAWTHORNE DR",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530801109",
            "telephone_number": "262-675-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIFTER",
        "first_name": "RONALD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5000468015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saukville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.