Individual provider Active NPI

Lisa Jane Stimmel, DDS, MS

  • Pediatric Dentistry
  • Centennial, CO
National Provider Identifier
1376578716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
06708 Issued in CO
Practice address
8194 S Holly St
Centennial, CO 80122-4004
Phone
(303) 771-8300
Fax
(303) 771-2298
NPI assigned
Jul 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 06708 CO Primary

Addresses

Primary practice location

8194 S Holly St
Centennial, CO 80122-4004

Mailing address

8024 S Albion St
Centennial, CO 80122-3900
Phone (303) 771-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
06708COMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376578716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8024 S ALBION ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801223900",
            "telephone_number": "303-771-8300",
            "fax_number": "303-771-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8194 S HOLLY ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801224004",
            "telephone_number": "303-771-8300",
            "fax_number": "303-771-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIMMEL",
        "first_name": "LISA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "06708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.