Individual provider Active NPI

Michelle V Stovall, D.D.S.

  • Pediatric Dentistry
  • Gettysburg, PA
National Provider Identifier
1376743377
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS038164 Issued in PA
Practice address
353 York St
Gettysburg, PA 17325-1953
Phone
(717) 334-8193
Fax
(717) 334-0884
NPI assigned
Jul 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 13847 MD
Pediatric Dentistry 1223P0221X DS038164 PA Primary

Addresses

Primary practice location

353 York St
Gettysburg, PA 17325-1953

Mailing address

353 York St
Gettysburg, PA 17325-1953
Phone (717) 334-8193

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

State licenses

LicenseStateTypeSpecialty
13847MDMDPediatric Dentist
DS038164PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Seidel and Defilippo Dentistry Partnership Pediatric Dentistry Past Accepting new patients
Cleveland L. Null, DDS, PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1376743377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 YORK ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173251953",
            "telephone_number": "717-334-8193",
            "fax_number": "717-334-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 YORK ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173251953",
            "telephone_number": "717-334-8193",
            "fax_number": "717-334-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "MICHELLE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "13847",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS038164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.