Individual provider Active NPI

Robert L Stonerock, DDS

  • Pediatric Dentistry
  • Fort Bragg, NC
National Provider Identifier
1467560490
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
ID0020 Issued in SC
Practice address
Department of the Army Dental Activity Stop
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001
Phone
(910) 396-5610
Fax
(910) 396-7017
NPI assigned
Aug 29, 2006
Last updated
May 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X ID0020 SC Primary
Pediatric Dentistry 1223P0221X 801 CO

Addresses

Primary practice location

Department of the Army Dental Activity Stop
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001

Mailing address

Department of the Army Dental Activity Stop
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001
Phone (910) 396-5610

Other identifiers 1

IdentifierTypeStateIssuer
ZX0020MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
801COMDMarriage & Family Therapist
ID0020SCMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1467560490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF THE ARMY DENTAL ACTIVITY STOP",
            "address_2": "2817 REILLY RD, MCDS-NA-B",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-5610",
            "fax_number": "910-396-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF THE ARMY DENTAL ACTIVITY STOP",
            "address_2": "2817 REILLY RD, MCDS-NA-B",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-396-5610",
            "fax_number": "910-396-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONEROCK",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "ID0020",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "801",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX0020",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.