Kenneth Marne Stinchfield, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D8179 Issued in OR

Practice address

405 SE 133Rd Ave
Portland, OR 97233-1809

Phone

(503) 255-7188

Fax

(503) 261-0971

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1326104076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2125",
            "fax_number": "503-526-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 SE 133RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331809",
            "telephone_number": "503-255-7188",
            "fax_number": "503-261-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINCHFIELD",
        "first_name": "KENNETH",
        "middle_name": "MARNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D8179",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00005871",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D-3945-OS",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stillmind LLC
• Gregory Howard Stilson, D.C.
• James Stilwell
• Kamela Stilwell, M.D.
• Kyle Stilwell
• Michael Stine, LPC, MS
• Daniel Stinea, LPC, CADC III
• Lauren Elizabeth Stines, QMHA
• Elizabeth J Stinson, MFT
• Jenelle Lynn Stinson, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Portland, OR
• Providers in Portland, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.