Individual provider Active NPI

Scot Stromsta, DDS

  • Dentist
  • Portage, MI
National Provider Identifier
1700996550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
012397 Issued in MI
Practice address
712 West Centre Ave
Portage, MI 49024-5310
Phone
(269) 323-0335
Fax
(269) 323-3396
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 012397 MI Primary

Addresses

Primary practice location

712 West Centre Ave
Portage, MI 49024-5310

Mailing address

712 West Centre Ave
Portage, MI 49024-5310
Phone (269) 323-0335

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
012397MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700996550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 WEST CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245310",
            "telephone_number": "269-323-0335",
            "fax_number": "269-323-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 WEST CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245310",
            "telephone_number": "269-323-0335",
            "fax_number": "269-323-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROMSTA",
        "first_name": "SCOT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "012397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.