NPIMap

Organization Active NPI

Stephanie B Loller DDS PC

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1437697968
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44610 Issued in CA
Legal business name
STEPHANIE B LOLLER DDS PC
Practice address
891 S Bascom Ave
San Jose, CA 95128-2627
Phone
(408) 298-0777
Fax
(408) 298-3143
NPI assigned
Feb 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Dr. Stephanie B Loller I, DDSNPI 1316943954
Title
Owner
Phone
(408) 298-0777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 44610 CA Primary

Addresses

Primary practice location

891 S Bascom Ave
San Jose, CA 95128-2627

Mailing address

891 S Bascom Ave
San Jose, CA 95128-2627
Phone (408) 298-0777

Other names 1

  • Inspira Advanced Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

891 S Bascom Ave
San Jose, CA 95128
Phone (408) 298-0777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1437697968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282627",
            "telephone_number": "408-298-0777",
            "fax_number": "408-298-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282627",
            "telephone_number": "408-298-0777",
            "fax_number": "408-298-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE B LOLLER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "LOLLER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-298-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inspira Advanced Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.