Brian William Stancoven, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0021833 Issued in TX

Practice address

1 Jarrett White Road, BLDG 320 Krukowski Street
USA Dentac
Tripler AMC, HI 96859-5000

Phone

(808) 433-1021

Fax

(808) 433-3928

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1508823840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE ROAD",
            "address_2": "US ARMY DENTAL ACTIVITY HAWAII",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "96859",
            "telephone_number": "808-433-1021",
            "fax_number": "808-433-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE ROAD, BLDG 320 KRUKOWSKI STREET",
            "address_2": "USA DENTAC",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595000",
            "telephone_number": "808-433-1021",
            "fax_number": "808-433-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCOVEN",
        "first_name": "BRIAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21833",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "0021833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel James Sowards, MD
• Brian Paul Spence, DDS
• Jordan Spradlin, DPT
• Richard S. Stack, M.D.
• Lauren Staiger, MD
• John Jeffrey Stasinos, M.D.
• Samantha Renee Steiss, DO
• Justin M Stephens, DMD
• Kelly Jongwon Sun, MD
• Kayla Sutton

• Periodontics in Tripler AMC, HI
• Providers in Tripler AMC, HI by specialty
• Periodontics in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.