Mark Alan Stahl, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010762A Issued in IN

Practice address

6919 E 10TH St
Indianapolis, IN 46219-4893

Phone

(317) 358-8885

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1396955092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 WESTFIELD CT W APT C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201162",
            "telephone_number": "206-743-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6919 E 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194893",
            "telephone_number": "317-358-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010762A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60076890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Gordene Stafko, OTR
• Charmion Lynn Stager, O.D.
• William Alan Staggs
• Kathryn Ann Stahl, NP
• Kelly Ann Stahl, MOT OTR
• Phillip Ashton Stahl, DDS
• Robin D Stahl, R.D., C.D.
• Stephanie Marie Stahl, MD
• Tasha Stahly
• Sarah Ann Stainko, NP

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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.