Brooke Manning Stoltz, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2832 Issued in SC

Practice address

2248 Pine Street
West Columbia, SC 29170-1442

Phone

(803) 755-0039

Fax

(803) 755-0007

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• Three Fountains Family Dental Inc

  • General Practice Dentistry
  • West Columbia, SC
  • NPI 1295805042
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366531675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 PINE STREET",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291701442",
            "telephone_number": "803-755-0039",
            "fax_number": "803-755-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2248 PINE STREET",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291701442",
            "telephone_number": "803-755-0039",
            "fax_number": "803-755-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTZ",
        "first_name": "BROOKE",
        "middle_name": "MANNING",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "2832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elva Stinson, M.D.
• Scott Stockholm, DO
• Taylor Stoll, PT, DPT
• Chelsea Stollar
• Bradley Paul Stoltz, PHARMD., RPH.
• Peter Otto Stoltz, DMD
• Jared R Stone, MD
• Kaitlin Stone, RBT
• Kimberly Ann Stone, M.D.
• Timothy Harold Stone Jr., P.T.

• Dentist in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Dentist in South Carolina

• 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.
• 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.