Susan Mary Stovall, DENTURIST LD

Primary specialty

DenturistTaxonomy code 122400000X

License

DT DO 981893 Issued in OR

Practice address

16130 SE 82ND Drive
Swiss Denture Center
Clackamas, OR 97014

Phone

(503) 657-6500

Fax

(503) 557-0412

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487851614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16130 SE 82ND DRIVE",
            "address_2": "SWISS DENTURE CENTER",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159587",
            "telephone_number": "503-657-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16130 SE 82ND DRIVE",
            "address_2": "SWISS DENTURE CENTER",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97014",
            "telephone_number": "503-657-6500",
            "fax_number": "503-557-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "DENTURIST LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "OR",
            "license": "DT DO 981893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy Christopher Stoeber, MD
• Jeffrey M Stolsig, DO
• Christie Stoneback, PHARM.D.
• Cathy Stores
• Ann Stout, R.PH.
• Joanne Tuyet Stowell, LCSW
• Richard Strauss, MD
• Amy Strawser, QMHA
• Kelsey Streeter, NP, FNP
• Noah Charles Stroup, MS, LPC, CADC I

• Denturist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Denturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.