Individual provider Active NPI

Stephen Richard Stanfield, DDS

  • Pediatric Dentistry
  • Phoenix, AZ
National Provider Identifier
1669756342
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D009010 Issued in AZ
Practice address
21001 N Tatum Blvd
Phoenix, AZ 85050-4206
Phone
(480) 515-5437
NPI assigned
Sep 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D009010 AZ Primary

Addresses

Primary practice location

21001 N Tatum Blvd
Phoenix, AZ 85050-4206

Mailing address

21001 N Tatum Blvd
Phoenix, AZ 85050-4206
Phone (480) 515-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150811004737 AZ Order and Referring Only - DentistPractitioner - Dentist 5193030773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D009010AZMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1669756342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504206",
            "telephone_number": "480-515-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504206",
            "telephone_number": "480-515-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFIELD",
        "first_name": "STEPHEN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-29",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D009010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.