Individual provider Active NPI

Dale Leonard Stone, DMD

  • Dentist
  • Lavonia, GA
National Provider Identifier
1558417006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
008810 Issued in GA
Practice address
5771 Vickery St
Lavonia, GA 30553
Phone
(706) 356-8212
Fax
(706) 356-8083
NPI assigned
Jan 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 008810 GA Primary

Addresses

Primary practice location

5771 Vickery St
Lavonia, GA 30553

Mailing address

5771 Vickery St
Lavonia, GA 30553
Phone (706) 356-8212

Other identifiers 1

IdentifierTypeStateIssuer
000137849AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008810GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
D L Stone DMD LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558417006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5771 VICKERY ST",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "30553",
            "telephone_number": "706-356-8212",
            "fax_number": "706-356-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5771 VICKERY ST",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "30553",
            "telephone_number": "706-356-8212",
            "fax_number": "706-356-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "DALE",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "008810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000137849A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lavonia, GA

Sources for this page

  • 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.