Individual provider Active NPI

Marc Stephen Stojkovich, D.D.S.

  • General Practice Dentistry
  • Highland, IN
National Provider Identifier
1386990893
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011800A Issued in IN
Practice address
8730 Indianapolis Blvd
Highland, IN 46322-1584
Phone
(219) 972-3309
NPI assigned
Aug 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12011800A IN Primary

Addresses

Primary practice location

8730 Indianapolis Blvd
Highland, IN 46322-1584

Mailing address

8730 Indianapolis Blvd
Highland, IN 46322-1584
Phone (219) 972-3309

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20151116001267 IN Order and Referring Only - DentistPractitioner - Dentist 8921318312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011800AINMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1386990893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8730 INDIANAPOLIS BLVD",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221584",
            "telephone_number": "219-972-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8730 INDIANAPOLIS BLVD",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463221584",
            "telephone_number": "219-972-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOJKOVICH",
        "first_name": "MARC",
        "middle_name": "STEPHEN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.