NPIMap

Organization Active NPI

Carla G Stappenbeck DDS LLC

Doing business as Pooler Pediatric Dentistry

  • Pediatric Dentistry
  • Pooler, GA
National Provider Identifier
1396122834
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CARLA G STAPPENBECK DDS LLC
Doing business as
Pooler Pediatric Dentistry
Practice address
120 Towne Center Dr Ste 500
Pooler, GA 31322-2034
Phone
(912) 376-9296
Fax
(912) 376-9076
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Dr. Carla Guzman Stappenbeck, DDSNPI 1245447366
Title
Pediatric Dentist
Phone
(912) 376-9296

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

120 Towne Center Dr Ste 500
Pooler, GA 31322-2034

Mailing address

120 Towne Center Dr Ste 500
Pooler, GA 31322-2034
Phone (912) 376-9296

Other names 1

  • Pooler Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

120 Towne Center Dr
Ste 500
Pooler, GA 31322
Phone (912) 376-9296

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": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1396122834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 TOWNE CENTER DR STE 500",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222034",
            "telephone_number": "912-376-9296",
            "fax_number": "912-376-9076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TOWNE CENTER DR STE 500",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222034",
            "telephone_number": "912-376-9296",
            "fax_number": "912-376-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLA G STAPPENBECK DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "STAPPENBECK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "GUZMAN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "912-376-9296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pooler Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.