Amy Stark, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

R471 Issued in MN

Practice address

606 24TH Ave S Ste 200
Minneapolis, MN 55454-1437

Phone

(612) 659-8689

Fax

(612) 658-8690

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1437464294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 CEDAR LAKE RD S APT 7",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163761",
            "telephone_number": "612-206-5623",
            "fax_number": "612-659-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 24TH AVE S STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541437",
            "telephone_number": "612-659-8689",
            "fax_number": "612-658-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "R471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Star Home Healthcare LLC
• Angela Star
• Constantin N Starchook, MD
• Nancy Stark Opsahl
• Amie Stark, RN
• Jenna Stark
• John Gregory Stark, MD
• Matthew Jon Stark, DDS
• Molly Marie Stark, DPT
• Monica Dorothy Stark, PT, DPT

• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.