Lisa A Stahlecker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS027426L Issued in PA

Practice address

2410 N Broad St
Colmar, PA 18915-9701

Phone

(215) 822-7070

Fax

(215) 997-8290

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Joel Chanen DDS PC

  • Dentist
  • Colmar, PA
  • NPI 1427069343
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in PA

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

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396756201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 N BROAD ST",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189159701",
            "telephone_number": "215-822-7070",
            "fax_number": "215-997-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 N BROAD ST",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189159701",
            "telephone_number": "215-822-7070",
            "fax_number": "215-997-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLECKER",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027426L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "27426",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phyliss Shanken, M.A.
• Williard J Shanken, MD
• Shared Support, Inc.
• Sukhdev Singh, D.M.D.
• Cara Ann Slugaski, DMD
• Avril Hope Takiff, LCSW
• The Randolph Logan Group LLC
• The Randolph Logan Group LLC
• Thomas C Detweiler,MD
• Julia Thompson, LMFT

• All providers in Colmar, PA
• Dentist in Pennsylvania

• 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.