Active NPI
Stephanie Marie Ollom, DDS
- General Practice Dentistry
- Westerville, OH
National Provider Identifier
1649525213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30-24892
- Practice address
- 1245 S Sunbury Rd Ste 201
Westerville, OH 43081-9444 - Phone
- (614) 776-0505
- NPI assigned
- Jul 19, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019029173 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 30-24892 | OH | Primary |
Addresses
Primary practice location
1245 S Sunbury Rd Ste 201
Westerville, OH 43081-9444
Mailing address
7477 Ratchford CT
New Albany, OH 43054-8970
Phone (419) 906-7196
Other practice location 1
1327 N Cornell Ln
Wauseon, OH 43567-9206
Phone (419) 906-7196
Other practice location 2
7477 Ratchford Ct
New Albany, OH 43054-8970
Phone (419) 906-7196
Other names 1
- Dr. Stephanie Marie Stuck
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-24892 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523836800000",
"number": "1649525213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7477 RATCHFORD CT",
"city": "NEW ALBANY",
"state": "OH",
"postal_code": "430548970",
"telephone_number": "419-906-7196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 S SUNBURY RD STE 201",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430819444",
"telephone_number": "614-776-0505"
}
],
"practiceLocations": [
{
"address_1": "1327 N Cornell Ln",
"address_purpose": "LOCATION",
"city": "Wauseon",
"state": "OH",
"postal_code": "435679206",
"country_code": "US",
"telephone_number": "419-906-7196",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7477 Ratchford Ct",
"address_purpose": "LOCATION",
"city": "New Albany",
"state": "OH",
"postal_code": "430548970",
"country_code": "US",
"telephone_number": "419-906-7196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLLOM",
"first_name": "STEPHANIE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-19",
"last_updated": "2018-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019029173",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-24892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "STUCK",
"middle_name": "MARIE",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.