Mark F Stoner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010013A Issued in IN

Practice address

4116 E State Blvd
Fort Wayne, IN 46815-6911

Phone

(260) 485-8118

Fax

(260) 482-3750

NPI assigned

Feb 22, 2007

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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.

• Hale Family Dentistry Corp

  • Dentist
  • Fort Wayne, IN
  • NPI 1912569492
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285769299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156911",
            "telephone_number": "260-485-8118",
            "fax_number": "260-482-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468156911",
            "telephone_number": "260-485-8118",
            "fax_number": "260-482-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONER",
        "first_name": "MARK",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010013A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP NUMBER",
            "identifier": "9659",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Stoller, DDS, PA-C
• Macy Lana Stoller
• Thomas L Stoller, RPH
• Jeffrey Stone, RPH
• Shelby Payton Stone, PA-C
• Maxine Stoner, RN
• Makayla Stonestreet, RBT
• Rick Jarrett Storie, P.A.
• Joshua Stork, ATC, LAT, MBA
• Rylee Lynn Storms, PA-C

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• 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.