Individual provider Active NPI

Lynn Therese Stine, DDS

  • General Practice Dentistry
  • Vincennes, IN
National Provider Identifier
1407026933
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010706A Issued in IN
Practice address
706 S 15TH St
Vincennes, IN 47591-4356
Phone
(812) 882-1572
NPI assigned
Mar 12, 2008
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12010706A IN Primary

Addresses

Primary practice location

706 S 15TH St
Vincennes, IN 47591-4356

Mailing address

609 Grouseland Dr
Vincennes, IN 47591-5142
Phone (812) 886-3958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20160304000361 IN Order and Referring Only - DentistPractitioner - Dentist 1456657287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12010706AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Herman Family Dental,LLC General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1407026933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 GROUSELAND DR",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475915142",
            "telephone_number": "812-886-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S 15TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914356",
            "telephone_number": "812-882-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "LYNN",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010706A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.