Stan Edwin Edwards, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8733 Issued in OR

Practice address

1585 SW Marlow Ave Ste 220
Portland, OR 97225-5178

Phone

(503) 297-7231

Fax

(503) 291-1335

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

State licenses

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1477546570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 SW MARLOW AVE STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255178",
            "telephone_number": "503-297-7231",
            "fax_number": "503-291-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 SW MARLOW AVE STE 220",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255178",
            "telephone_number": "503-297-7231",
            "fax_number": "503-291-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "STAN",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009370",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8733",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Edwards, MD
• Patrick Stevens Edwards, E.F.D.A., R.D.A.
• Raymond S Edwards, MD
• Samantha L Edwards, LPC
• Sharon Renee Edwards, MD
• Teana Edwards
• Valerie Edwards, MS, RD, LD
• Victoria Ann Edwards, MS CCC-SLP
• Natasha Catherine Edwin, M.D.
• Katrina Eerkes

• All providers in Portland, OR
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.