Amanda Lynn Denomme-Stough, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019418 Issued in MI

Practice address

591 W Chicago St
Coldwater, MI 49036-9189

Phone

(517) 279-7900

Fax

(517) 279-7914

NPI assigned

Oct 18, 2006

Last updated

Sep 13, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Smile Avenue Family and Cosmetic Dentistry

  dba Smile Avenue Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Coldwater, MI
  • NPI 1992414981
  NPD

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1447331236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 W CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490369189",
            "telephone_number": "517-279-7900",
            "fax_number": "517-279-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 W CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490369189",
            "telephone_number": "517-279-7900",
            "fax_number": "517-279-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENOMME-STOUGH",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE",
            "identifier": "2901019418",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clair Dean
• Thomas Clay Deck, M.A, C.A.C.-I
• Matthew Laurence Decker, O.D.
• Betty Delong, N.P.
• Abraham John Demond, DC
• Nina Dickerson, LLPC
• Jessica Dickinson
• Debra M Dillon, DO
• Hailey Dawn Dirschell, RBT
• DJM Farms LLC (Coldwater Counseling Center)

• General Practice Dentistry in Coldwater, MI
• Providers in Coldwater, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.