Active NPI
Stephen Patrick Girdlestone, D.D.S
- Pediatric Dentistry
- Canton, OH
National Provider Identifier
1295803542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 30-020553
- Practice address
- 3801 Whipple Ave NW
Suite 4
Canton, OH 44718-4802 - Phone
- (330) 491-7777
- Fax
- (330) 491-8888
- NPI assigned
- Dec 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30-020553 | OH | Primary |
Addresses
Primary practice location
3801 Whipple Ave NW
Suite 4
Canton, OH 44718-4802
Mailing address
3801 Whipple Ave Suite 4
Canton, OH 44718
Phone (330) 491-7777
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30-020553 | OH | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295803542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 WHIPPLE AVE SUITE 4",
"city": "CANTON",
"state": "OH",
"postal_code": "44718",
"telephone_number": "330-491-7777",
"fax_number": "330-491-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 WHIPPLE AVE NW",
"address_2": "SUITE 4",
"city": "CANTON",
"state": "OH",
"postal_code": "447184802",
"telephone_number": "330-491-7777",
"fax_number": "330-491-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIRDLESTONE",
"first_name": "STEPHEN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30-020553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
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.