NPIMap

Organization Active NPI

Joe C. Stucky, DDS, PC

  • General Practice Dentistry
  • Montrose, CO
National Provider Identifier
1790153500
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7238 Issued in CO
Legal business name
JOE C. STUCKY, DDS, PC
Practice address
154 Colorado Ave
Suite #201
Montrose, CO 81401-3651
Phone
(970) 249-1898
Fax
(970) 240-3277
NPI assigned
Sep 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Ms. Lee C Edwards
Title
Office Manager
Phone
(970) 249-1898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7238 CO Primary

Addresses

Primary practice location

154 Colorado Ave
Suite #201
Montrose, CO 81401-3651

Mailing address

154 Colorado Ave
Suite #201
Montrose, CO 81401-3651
Phone (970) 249-1898

Other identifiers 2

IdentifierTypeStateIssuer
02072387MedicaidCO
04019311MedicaidCO

National Provider Directory

National Provider Directory

Locations

154 Colorado Ave
Ste 201
Montrose, CO 81401
Phone (970) 249-1898

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1790153500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 COLORADO AVE",
            "address_2": "SUITE #201",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013651",
            "telephone_number": "970-249-1898",
            "fax_number": "970-240-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 COLORADO AVE",
            "address_2": "SUITE #201",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013651",
            "telephone_number": "970-249-1898",
            "fax_number": "970-240-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOE C. STUCKY, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-249-1898",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02072387",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04019311",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.