Ronald Seth Stukalin, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

15826 Issued in TX

Practice address

5925 Forest LN Ste 318
Dallas, TX 75230-2776

Phone

(972) 490-4881

Fax

(972) 490-1270

NPI assigned

Mar 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• DRS. Stukalin, P.a.

  • Periodontics
  • Dallas, TX
  • NPI 1205988441
  NPD (past) Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841310406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 318",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302776",
            "telephone_number": "972-490-4881",
            "fax_number": "972-490-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 318",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302776",
            "telephone_number": "972-490-4881",
            "fax_number": "972-490-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKALIN",
        "first_name": "RONALD",
        "middle_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "15826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Stuckly
• Simon Studeny, MD
• Carissa Studer
• Jill Louise Studley
• Study Notes ABA
• Bryanna Stukes, MD
• Dedra Shatia Stukes
• Brianne Marie Stull, PA-C
• Karen Stull
• Gabriella Noelle Stump

• Periodontics in Dallas, TX
• Providers in Dallas, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.