Individual provider Active NPI

Jeffrey Stout, D.D.S.

  • General Practice Dentistry
  • Newark, DE
National Provider Identifier
1497809131
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1032 Issued in DE
Practice address
344 E Main St
Newark, DE 19711-7148
Phone
(302) 737-5170
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1032 DE Primary
Durable Medical Equipment & Medical Supplies 332B00000X G1-0001032 DE

Addresses

Primary practice location

344 E Main St
Newark, DE 19711-7148

Mailing address

344 E Main St
Newark, DE 19711-7148
Phone (302) 737-5170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20150528002277 DE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042530255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1032DEMDGeneral Practice Dentistry
G1-0001032DEMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Dental Associates PA General Practice Past Accepting new patients
Newark Dental Associates PA Durable Medical Equipment & Medical Supplies Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1497809131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E MAIN ST",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117148",
            "telephone_number": "302-737-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E MAIN ST",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197117148",
            "telephone_number": "302-737-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "1032",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "DE",
            "license": "G1-0001032",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.