Bruce Kenneth Stolle, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013967 Issued in MO

Practice address

2300 S Old Highway 94
Saint Charles, MO 63303-5622

Phone

(636) 928-8400

Fax

(636) 928-0480

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Arthur Westphal DMD and Bruce Stolle DMD PC

  • General Practice Dentistry
  • Saint Charles, MO
  • NPI 1003948027
  NPD (past) Authorized official

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700918711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 EMILY WAY CT",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630054252",
            "telephone_number": "636-530-9558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S OLD HIGHWAY 94",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035622",
            "telephone_number": "636-928-8400",
            "fax_number": "636-928-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLE",
        "first_name": "BRUCE",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly R Stillman, M.A,PLPC
• STL Speech & Language, LLC
• STL Speech Sisters LLC
• Vincent F. Stock, M.A.
• Elisabeth Stoll
• Paige Storts
• Paula Stout, M.S., CCC-SLP
• Robert Dennis Streer, RPH, MBA
• McKenzie Laine Struckhoff, MOT, OTR/L
• Allyson Strunk

• General Practice Dentistry in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.