Stephen J. Doelker DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

30013796 Issued in OH

Legal business name

STEPHEN J. DOELKER DDS LLC

Doing business as

Klermont 4 Kids & Adults 2

Practice address

497 W Main St
Batavia, OH 45103

Phone

(513) 735-9111

Fax

(513) 735-9222

NPI assigned

Aug 31, 2006

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William R Fry Jr., MBA

Title

Business Manager

Phone

(513) 735-9111

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Klermont 4 Kids & Adults 2 Doing business as

Locations

Practitioners 4

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.

• Lewis Clair Brokaw, DDS

  • Dentist
  • Batavia, OH
  • NPI 1215007406
  NPD (past)
• Andrew Michael Killgore, D.M.D.

  • General Practice Dentistry
  • Batavia, OH
  • NPI 1528078227
  NPD (past)
• Thomas A Phillips, D.D.S.

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1063465326
  NPD (past)
• Oneida Shushe, DDS

  • Dentist
  • Batavia, OH
  • NPI 1619711686
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1841301918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 W MAIN ST",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "45103",
            "telephone_number": "513-735-9111",
            "fax_number": "513-735-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 W MAIN ST",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "45103",
            "telephone_number": "513-735-9111",
            "fax_number": "513-735-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN J. DOELKER DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "513-735-9111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30013796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263610",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431158",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2554267",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klermont 4 Kids & Adults 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Marie Stahlecker, NP
• Sandra D. Stanford, MSPT
• Jane Steele
• Sarah Steele, CDCA
• Meagan Ashley Stegner, RN
• Stephen L. Claybon DDS, Inc.
• Hope Stephenson, LPN
• Katie Stephenson
• Jennifer Michelle Stimmell
• Christopher Stock

• Dentist in Batavia, OH
• Providers in Batavia, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.

Verify at the official NPI Registry.