Active NPI
William Nicholas Stathas, DDS
- General Practice Dentistry
- Wauwatosa, WI
National Provider Identifier
1306875646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2076G
- Practice address
- 2300 N Mayfair Rd
Suite 345
Wauwatosa, WI 53226-1505 - Phone
- (414) 456-9020
- Fax
- (414) 456-9021
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2076G | WI | Primary |
Addresses
Primary practice location
2300 N Mayfair Rd
Suite 345
Wauwatosa, WI 53226-1505
Mailing address
2323 N Mayfair Rd
Ste 420
Wauwatosa, WI 53226-1534
Phone (414) 456-9020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2076G | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1306875646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 N MAYFAIR RD",
"address_2": "STE 420",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532261534",
"telephone_number": "414-456-9020",
"fax_number": "414-456-9021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 N MAYFAIR RD",
"address_2": "SUITE 345",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532261505",
"telephone_number": "414-456-9020",
"fax_number": "414-456-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATHAS",
"first_name": "WILLIAM",
"middle_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "2076G",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.