Hidy Stavarache, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3084 Issued in NV

Practice address

9910 W Cheyenne Ave
#170
Las Vegas, NV 89129-7707

Phone

(702) 233-8371

Fax

(702) 233-8692

NPI assigned

Aug 12, 2006

Last updated

Jul 23, 2013By 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

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1457363350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 W CHEYENNE AVE",
            "address_2": "#170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297707",
            "telephone_number": "702-233-8371",
            "fax_number": "702-233-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9910 W CHEYENNE AVE",
            "address_2": "#170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297707",
            "telephone_number": "702-233-8371",
            "fax_number": "702-233-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVARACHE",
        "first_name": "HIDY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Staub, MS ED
• Sallye Louise Stauber, DNP, FNP-C
• Becky Staudacher, MS, BCBA
• Carol Staudt
• Debra J Stauffer, MNT
• Broderick Staves
• Derek Stazenski
• Pamela Lynn Stclair, M.D.
• Ste Medical Equipment Services LLC
• Steadfast Behavioral Clinic LLC

• General Practice Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.