Jennie-Leigh L Stoddart, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS03023L Issued in PA

Practice address

4102 Pinion Dr
Usaf Academy, CO 80840-2502

Phone

(719) 333-5192

NPI assigned

Aug 13, 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

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1619980760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDART",
        "first_name": "JENNIE-LEIGH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS03023L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Stanforth, ATC
• Kirk Bradley Stetson, D.D.S.
• Deborah L Stevens-Conrad, PHARMD
• Kendra Terry Stilwell, D.O.
• Timothy William Stilwell, PA-C
• Ernest Eugene Sullivent III, M.D.
• Dawn Michele Szarke, CPNP-BC
• Dawn A Tanner, LICSW
• Casey Taylor, DO
• Michael Thompson, PA

• General Practice Dentistry in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.

Verify at the official NPI Registry.