Kerry Jo Locklear Stanisic

Primary specialty

DentistTaxonomy code 122300000X

License

DN22556 Issued in FL

Practice address

3315 University Pkwy Unit 103
Sarasota, FL 34243-4240

Phone

(941) 822-8165

Fax

(941) 822-8257

NPI assigned

May 25, 2017

Sex

Female

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 FL

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

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720516453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 UNIVERSITY PKWY UNIT 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342434240",
            "telephone_number": "941-822-8165",
            "fax_number": "941-822-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 UNIVERSITY PKWY UNIT 103",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342434240",
            "telephone_number": "941-822-8165",
            "fax_number": "941-822-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANISIC",
        "first_name": "KERRY JO",
        "middle_name": "LOCKLEAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Ashlee Stanfield
• Dynie Stanford
• Kimberky Stanford, RN, BSBA, QMHP
• Gina Stangel, CRNA
• Eric J Stangl, PT
• Richard Allen Stanley, D.M.D.
• Stanleys Custom Eyewear Inc (Stanley'S Custom Eyewear)
• Mary Elizabeth Stanton, CRNA
• Marcia Best Staples, OTR
• Patricia A Staples, COTA

• Dentist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.