Individual provider Active NPI

David Eugene Stamos, DDS, MS

  • Endodontics
  • Independence, MO
National Provider Identifier
1467546085
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
013932 Issued in MO
Practice address
4731 S Cochise
Suite 221
Independence, MO 64055
Phone
(816) 478-8895
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 013932 MO Primary

Addresses

Primary practice location

4731 S Cochise
Suite 221
Independence, MO 64055

Mailing address

3320 Saddle Ridge CT.
Independence, MO 64057
Phone (816) 224-5840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170228002495 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042291494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
013932MOMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467546085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 SADDLE RIDGE CT.",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64057",
            "telephone_number": "816-224-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S COCHISE",
            "address_2": "SUITE 221",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64055",
            "telephone_number": "816-478-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMOS",
        "first_name": "DAVID",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MO",
            "license": "013932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.