Alvin J Stosich, MD, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

6434136-1205 Issued in UT

Practice address

6268 S 900 E
Ste 100
Salt Lake City, UT 84121-2497

Phone

(801) 566-5117

Fax

(801) 566-5119

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 25, 2018 through Feb 25, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aspire Surgical

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
  • NPI 1548792468
  NPD
• Ut Oms Specialty Dental Services PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • West Jordan, UT
  • NPI 1194582031
  NPD (past)
• Ut Oms Specialty Dental Services PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Heber City, UT
  • NPI 1831956770
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1689795114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 S 900 E",
            "address_2": "STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212497",
            "telephone_number": "801-566-5117",
            "fax_number": "801-566-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 S 900 E",
            "address_2": "STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212497",
            "telephone_number": "801-566-5117",
            "fax_number": "801-566-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOSICH",
        "first_name": "ALVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "6434136-9925",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NE",
            "license": "6395",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "UT",
            "license": "6434136-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Stormann
• Derek John Storrs, DPT
• Jonathan Storrs
• Grace Story
• Benjamin Neil Storz, MD
• Wei Hsin Stott
• Paige Stotts, MOT,OTR,CHT
• Kathy Stouffer
• Brandon Stout
• Chrystal Stout

• Oral & Maxillofacial Surgery (D.M.D.) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.