Individual provider Active NPI

Andrew T. Stahr, D.M.D.

  • Dentist
  • Paducah, KY
National Provider Identifier
1275731978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5786 Issued in KY
Practice address
1401 Broadway St
Paducah, KY 42001-2500
Phone
(270) 442-3136
NPI assigned
Jul 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5786 KY Primary

Addresses

Primary practice location

1401 Broadway St
Paducah, KY 42001-2500

Mailing address

1401 Broadway St
Paducah, KY 42001-2500
Phone (270) 442-3136

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
5786KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275731978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012500",
            "telephone_number": "270-442-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420012500",
            "telephone_number": "270-442-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHR",
        "first_name": "ANDREW",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • 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.