Stonehaven Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

STONEHAVEN DENTAL PLLC

Practice address

824 Hewitt Dr # 300
Waco, TX 76712-6656

Phone

(972) 869-3789

Fax

(972) 869-3791

NPI assigned

Feb 25, 2014

Organization subpart

No

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

Authorized official

Name

Mary Pu

Title

VP of Finance

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Stonehaven Dental Doing business as

Locations

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1326463555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734753",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753734753",
            "telephone_number": "972-869-3789",
            "fax_number": "972-869-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 HEWITT DR # 300",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126656",
            "telephone_number": "972-869-3789",
            "fax_number": "972-869-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEHAVEN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "PU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonehaven Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha A Stockreef, RN
• Richard A. Stolze, PA-C
• Tlythia Stone-Isaac, RBT
• Kelsi Stone, MSN, APRN, FNP-C
• Mikayla Stone, LCSW
• Susan B. Stoner, SLP
• Kimberly P Stonestreet, COTA
• Ryan Jared Storevik
• Mackenzie Antonia Story
• Mark W Story, MD

• Dentist in Waco, TX
• Providers in Waco, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.