Active NPI
Dawn Marie Stavish, DDS
- Dentist
- Mankato, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13185
- Practice address
- 309 Holly LN
Mankato, MN 56001-5422 - Phone
- (507) 388-2120
- NPI assigned
- Jun 13, 2005
- Last updated
- Apr 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D13185 | MN | Primary |
Addresses
Primary practice location
309 Holly LN
Mankato, MN 56001-5422
Mailing address
309 Holly LN
Mankato, MN 56001-5422
Phone (507) 388-2120
Other practice location 1
101 Martin Luther King Dr
Mankato, MN 56001-6460
Phone (507) 594-6500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13185 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients |
Locations
101 Martin Luther King Dr
Mankato, MN 56001
Phone (507) 385-6500
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mayo Clinic Health System - Mankato
- Multi-Specialty Clinic/Center
- Mankato, MN
- NPI 1578545422
-
dba Mayo Clinic Health System-Waseca
- Multi-Specialty Clinic/Center
- Waseca, MN
- NPI 1518494251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1528063955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 HOLLY LN",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015422",
"telephone_number": "507-388-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 HOLLY LN",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015422",
"telephone_number": "507-388-2120"
}
],
"practiceLocations": [
{
"address_1": "101 Martin Luther King Dr",
"address_purpose": "LOCATION",
"city": "Mankato",
"state": "MN",
"postal_code": "560016460",
"country_code": "US",
"telephone_number": "507-594-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STAVISH",
"first_name": "DAWN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-13",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.