Dedra Shatia Stukes

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Practice address

100 N Henderson Ave Apt 201
Dallas, TX 75214

Phone

(833) 336-6002

NPI assigned

Nov 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1689448151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST # 4922",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "833-336-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HENDERSON AVE APT 201",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75214",
            "telephone_number": "833-336-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKES",
        "first_name": "DEDRA",
        "middle_name": "SHATIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Studer
• Jill Louise Studley
• Study Notes ABA
• Ronald Seth Stukalin, D.D.S., M.S.
• Bryanna Stukes, MD
• Brianne Marie Stull, PA-C
• Karen Stull
• Gabriella Noelle Stump
• Katherine Anne Stumpf, M.D
• Chrysty Delayne Sturdivant, OTR

• Clinical Medical Laboratory in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.