Active NPI
Chad Michael Stoker, DDS
- Dental Anesthesiology
- Phoenix, AZ
National Provider Identifier
1629025259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- D5354
- Practice address
- 13601 N Canterbury Dr
Phoenix, AZ 85023-6290 - Phone
- (602) 459-7456
- NPI assigned
- May 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3093873-9924 | UT | |
| Dentist | 122300000X | 5354 | AZ | |
| Dental Anesthesiology | 1223D0004X | 11707 | NC | |
| Anesthesiology Physician | 207L00000X | 11707 | NC | |
| Dental Anesthesiology | 1223D0004X | D5354 | AZ | Primary |
Addresses
Primary practice location
13601 N Canterbury Dr
Phoenix, AZ 85023-6290
Mailing address
625 W Southern Ave Ste E-145
Mesa, AZ 85210-5030
Other practice location 1
2643 Randleman Rd
Greensboro, NC 27406-5153
Phone (336) 544-2758
Other practice location 2
625 W Southern Ave Ste E-145
Mesa, AZ 85210-5030
Phone (480) 628-1556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 571887 | Medicaid | AZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5354 | AZ | MD | Dentist |
| 3093873-9924 | UT | MD | Dentist |
| D5354 | AZ | MD | Dentist Anesthesiologist |
| 11707 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comfort Care Anesthesia, LLC | Dental Anesthesiology | 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 and National Provider Directory roles.
-
- Dental Anesthesiology
- Mesa, AZ
- NPI 1881185791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1629025259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 W SOUTHERN AVE STE E-145",
"city": "MESA",
"state": "AZ",
"postal_code": "852105030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13601 N CANTERBURY DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850236290",
"telephone_number": "602-459-7456"
}
],
"practiceLocations": [
{
"address_1": "2643 Randleman Rd",
"address_purpose": "LOCATION",
"city": "Greensboro",
"state": "NC",
"postal_code": "274065153",
"country_code": "US",
"telephone_number": "336-544-2758",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "625 W Southern Ave Ste E-145",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852105030",
"country_code": "US",
"telephone_number": "480-628-1556",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOKER",
"first_name": "CHAD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-28",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "3093873-9924",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "5354",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "NC",
"license": "11707",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "11707",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "AZ",
"license": "D5354",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "571887",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.