Stephen T Canale, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00011153 Issued in WA

Practice address

560 Quileute Heights
Lapush, WA 98350

Phone

(360) 374-6984

Fax

(360) 374-5448

NPI assigned

Dec 20, 2007

Last updated

Dec 20, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Dentist

Education

Nova Southeastern Univ College of Dental Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1639036924
  NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1700526852
  NPD
• Quileute Tribal Council

  • Clinic/Center
  • La Push, WA
  • NPI 1548329105
  NPD (past)

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1366626715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "LA PUSH",
            "state": "WA",
            "postal_code": "983500189",
            "telephone_number": "360-374-6984",
            "fax_number": "360-374-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 QUILEUTE HEIGHTS",
            "city": "LAPUSH",
            "state": "WA",
            "postal_code": "98350",
            "telephone_number": "360-374-6984",
            "fax_number": "360-374-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALE",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00011153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400221",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7084486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Marie Barrera, CDP
• Stephanie Marie Bechtold, ARNP
• Scott Bradley Chelgren, DDS
• Coastline Body and Mind Massage LLC
• Yvonne K Davis, COMMUNITY HEALTH REP
• Norman Philip Englund, MSW
• Sarah Maclovia Fletcher, REGISTERED NURSE

• General Practice Dentistry in La Push, WA
• Providers in La Push, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.