Active NPI
Michael Stahl, DMD
- General Practice Dentistry
- Ithaca, NY
National Provider Identifier
1770546095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22715
- Practice address
- 2309 N Triphammer Rd
Ithaca, NY 14850-1060 - Phone
- (607) 257-8065
- NPI assigned
- Apr 8, 2006
- Last updated
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22715 | NJ | Primary |
Addresses
Primary practice location
2309 N Triphammer Rd
Ithaca, NY 14850-1060
Mailing address
2309 N Triphammer Rd
Ithaca, NY 14850-1060
Phone (607) 257-8065
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22715 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1770546095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 N TRIPHAMMER RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501060",
"telephone_number": "607-257-8065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2309 N TRIPHAMMER RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148501060",
"telephone_number": "607-257-8065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAHL",
"first_name": "MICHAEL",
"name_prefix": "Ms.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-08",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.