Marilyn J Stolberg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901013275 Issued in MI

Practice address

160 E Broadway Ave
Muskegon, MI 49444-2102

Phone

(231) 733-1224

NPI assigned

Jul 12, 2006

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

Other identifiers 1

Other names 1

• Ms. Marilyn Jean Ryden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Elder Eye Care Group PLC

  • Optometrist
  • Spring Lake, MI
  • NPI 1477617579
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1619902921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442102",
            "telephone_number": "231-733-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442102",
            "telephone_number": "231-733-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLBERG",
        "first_name": "MARILYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744409338",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "RYDEN",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beth Ann Stille, NP
• Kristen Stimac
• Joshua Stinger
• Wendy McDaniel Stinson, MA, LLPC
• Alexander Stockwell, PHARMD
• Lauren Elizabeth Stolzman, PA-C
• Kevin Thomas Stone, M.D.
• Matthew Allen Stonehouse
• Melanie Renee Opal Stopfer, M.S.
• Brian R Stork, M.D.

• Dentist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.