Active NPI
Jan Steven Stahl, DDS
- Dentist
- Glen Head, NY
National Provider Identifier
1669742342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30676
- Practice address
- 345 Frost Pond Rd
Glen Head, NY 11545-2402 - Phone
- (516) 697-5213
- NPI assigned
- Jan 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30676 | NY | Primary |
Addresses
Primary practice location
345 Frost Pond Rd
Glen Head, NY 11545-2402
Mailing address
345 Frost Pond Rd
Glen Head, NY 11545-2402
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 |
|---|---|---|---|
| 30676 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1669742342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 FROST POND RD",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 FROST POND RD",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452402",
"telephone_number": "516-697-5213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAHL",
"first_name": "JAN",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-11",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "30676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Head, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.