Individual provider Active NPI

Stephanie Zastrow, DDS, MBA

  • Oral and Maxillofacial Surgery (Dentist)
  • Bradenton, FL
National Provider Identifier
1801287651
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN23983 Issued in FL
Practice address
3914 9TH Ave W
Bradenton, FL 34205
Phone
(941) 747-5597
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN23983 FL Primary

Addresses

Primary practice location

3914 9TH Ave W
Bradenton, FL 34205

Mailing address

3914 9TH Ave W
Bradenton, FL 34205-1704
Phone (941) 747-5597

Other practice location 1

1430 John Wesley Gilbert Drive
Augusta, GA 30912
Phone (612) 719-0129

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190924001743 FL Order and Referring Only - DentistPractitioner - Orthopedic SurgeryPractitioner - Dentist 4486984135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Troxler & Smith D.D.S PA PastSince Jul 25, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1801287651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 9TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342051704",
            "telephone_number": "941-747-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 9TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34205",
            "telephone_number": "941-747-5597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 John Wesley Gilbert Drive",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30912",
            "country_code": "US",
            "telephone_number": "612-719-0129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZASTROW",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DDS, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN23983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.