Stadium Denture Center, Inc.

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

1045-4114 Issued in WV

Legal business name

STADIUM DENTURE CENTER, INC.

Practice address

3015 Dudley Ave
Parkersburg, WV 26104-1817

Phone

(304) 615-9852

NPI assigned

Dec 8, 2016

Organization subpart

No

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

Authorized official

Name

Margie Allen

Title

President

Phone

(304) 615-9852

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1730623885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041817",
            "telephone_number": "304-615-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261041817",
            "telephone_number": "304-615-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIUM DENTURE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-615-9852"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "WV",
            "license": "1045-4114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Staats
• Luanna Staats
• Tara Lynn Staats, NP-C
• Melissa Stackpole
• Philp Marsh Stadelman, CARE COORDINATOR
• Gena Stalford
• Anna R Stalnaker
• Richard E Stanley, LPC
• Tabitha Stanley
• Dylan Stansberry

• Dental Laboratory in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Dental Laboratory in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.