NPIMap

Organization Active NPI

G. B. Stahl, DDS, PLLC

  • Dentist
  • Bellevue, WA
National Provider Identifier
1487200531
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
G. B. STAHL, DDS, PLLC
Practice address
14030 NE 24TH St
Suite 100
Bellevue, WA 98007
Phone
(425) 641-3668
Fax
(425) 747-7611
NPI assigned
Aug 14, 2019
Organization subpart
Yes
Parent organization
GANNON B. STAHL DDS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Authorized official

Name
Dr. Gannon Stahl, DDSNPI 1598959413
Title
Owner
Phone
(425) 641-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

14030 NE 24TH St
Suite 100
Bellevue, WA 98007

Mailing address

14030 NE 24TH St
Suite 100
Bellevue, WA 98007
Phone (425) 641-3668

National Provider Directory

National Provider Directory
Part of
Gannon B Stahl DDS PC

Locations

14030 NE 24th St
Ste 100
Bellevue, WA 98007
Phone (425) 641-3668

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1487200531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14030 NE 24TH ST",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-641-3668",
            "fax_number": "425-747-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14030 NE 24TH ST",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-641-3668",
            "fax_number": "425-747-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. B. STAHL, DDS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GANNON B. STAHL DDS PC",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "STAHL",
        "authorized_official_first_name": "GANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-641-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.