Individual provider Active NPI

Stanley David Snyder, DMD

  • General Practice Dentistry
  • Maryville, MO
National Provider Identifier
1669588075
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015369 Issued in MO
Practice address
2825 South Main Street
Maryville, MO 64468
Phone
(660) 582-8601
Fax
(660) 582-8630
NPI assigned
Aug 21, 2006
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
General Practice Dentistry 1223G0001X 015369 MO Primary

Addresses

Primary practice location

2825 South Main Street
Maryville, MO 64468

Mailing address

2825 South Main Street
Maryville, MO 64468
Phone (660) 582-8601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20160526001999 MO Order and Referring Only - DentistPractitioner - Dentist 5698065076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669588075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 SOUTH MAIN STREET",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "64468",
            "telephone_number": "660-582-8601",
            "fax_number": "660-582-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SOUTH MAIN STREET",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "64468",
            "telephone_number": "660-582-8601",
            "fax_number": "660-582-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "STANLEY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.