Stout Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

STOUT DENTAL CORPORATION

Doing business as

Missouri Flat Dental Group

Practice address

3967 Missouri Flat Road
Suite 120
Placerville, CA 95667

Phone

(530) 642-2876

Fax

(530) 295-8168

NPI assigned

Nov 13, 2014

Last updated

Feb 4, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Stout, DDS

Title

Owner

Phone

(530) 642-2876

Specialties & licenses 1

Addresses

Other names 1

• Missouri Flat Dental Group Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Annie Chandy

  • Dentist
  • North Highlands, CA
  • NPI 1881241164
  NPD (past)
• Elena Dupalo, DDS

  • General Practice Dentistry
  • Placerville, CA
  • NPI 1730767666
  NPD (past)
• Juan Ramirez

  • Dentist
  • Placerville, CA
  • NPI 1124981568

  Multi-Specialty

  NPD (past)
• Ryan R Zleik, DDS

  • General Practice Dentistry
  • Placerville, CA
  • NPI 1386326361
  NPD (past)

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1396141750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3967 MISSOURI FLAT ROAD",
            "address_2": "SUITE 120",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-642-2876",
            "fax_number": "530-295-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOUT DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-642-2876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Flat Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Missouri Flat Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Ivanovsky Stobaugh, LCSW
• Susan Alleene Stoeffler, MFT
• Cathryn Mary Stoffan
• Sandy Stokes, RN, PHN, MSN
• Sharon D Stone, FNP
• Chanel Marie Striffler, ASW
• Dustin Benjamin Stucki, M.ED. MFT
• Adam Styles, DPT
• Ashley Sullivan, RADT-1
• Kathleen Scarlett Sullivan, MFT

• General Practice Dentistry in Placerville, CA
• Providers in Placerville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.