Stacy Nadeen Butler, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008526 Issued in CT

Practice address

165 Miller St
Meriden, CT 06450-4256

Phone

(203) 639-3500

Fax

(203) 639-3509

NPI assigned

Jun 22, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396741658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SCHOOLHOUSE XING",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091339",
            "telephone_number": "860-257-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MILLER ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504256",
            "telephone_number": "203-639-3500",
            "fax_number": "203-639-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "STACY",
        "middle_name": "NADEEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Burke
• Michael Anthony Burke, LADC, LMSW, CCDP-D,
• Brandon Burns
• Mark S Burwick, DDS
• Amanda Butkiewicz, PHARM. D
• Emily Buyak
• Alexis Cable, SPEECH THERAPY
• Erin Cathryn Caffrey, MD
• Sean M. Caffyn, DO
• Alena Joy Caglar, LCSW

• General Practice Dentistry in Meriden, CT
• Providers in Meriden, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.