Organization Active NPI

Stebbins Dental Studio, Inc.

  • Dentist
  • Whitefish, MT
National Provider Identifier
1376929083
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STEBBINS DENTAL STUDIO, INC.
Practice address
401 Baker Ave Ste a
Whitefish, MT 59937-2499
Phone
(406) 862-3503
NPI assigned
Aug 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Dr. Mandrea Lynn Stebbins, D.M.D.NPI 1760504484
Title
Owner
Phone
(406) 862-3503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

401 Baker Ave Ste a
Whitefish, MT 59937-2499

Mailing address

PO Box 517
Whitefish, MT 59937-0517
Phone (406) 862-3503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180330000863 MT DME Supplier - Oral Surgery - Dentist 0345502449 Practice locations: Whitefish, MT

National Provider Directory

National Provider Directory

Locations

401 Baker Ave
Ste A
Whitefish, MT 59937
Phone (406) 862-3503

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1376929083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599370517",
            "telephone_number": "406-862-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAKER AVE STE A",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372499",
            "telephone_number": "406-862-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEBBINS DENTAL STUDIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "STEBBINS",
        "authorized_official_first_name": "MANDREA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-862-3503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.