Catherine Susan Stark, RDH, ORALFACIAL MYOL

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH007569 Issued in FL

Practice address

3930 S Nova Rd
#201
Port Orange, FL 32127-9281

Phone

(386) 212-5071

Fax

(603) 687-4663

NPI assigned

Jul 28, 2009

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1740411537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 S NOVA RD",
            "address_2": "#201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279281",
            "telephone_number": "386-212-5071",
            "fax_number": "603-687-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 S NOVA RD",
            "address_2": "#201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279281",
            "telephone_number": "386-212-5071",
            "fax_number": "603-687-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "CATHERINE",
        "middle_name": "SUSAN",
        "credential": "RDH, ORALFACIAL MYOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH007569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anunporn Srisawat, M.D.
• Shannon St Amant, D.C.
• Lisa St. Louis, PHARMD
• Stacy O'Brien Audiology
• Donna Starcher
• Crystal Starkes
• Michelle Mattera Starkey
• Marcy Starling, ARNP, FNP-BC
• Christopher Tyler Staten
• Kenneth Lee Staudt Jr., DDS MPH

• Dental Hygienist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Dental Hygienist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.