Active NPI
Dositej Stulic, D.D.S.
- Dentist
- Glendale, AZ
National Provider Identifier
1851512123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7132
- Practice address
- 5750 W Thunderbird Rd
Suite F600
Glendale, AZ 85306-4660 - Phone
- (602) 978-5900
- Fax
- (602) 978-5909
- NPI assigned
- May 2, 2007
- Last updated
- Aug 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D7132 | AZ | Primary |
Addresses
Primary practice location
5750 W Thunderbird Rd
Suite F600
Glendale, AZ 85306-4660
Mailing address
5750 W Thunderbird Rd
Suite F600
Glendale, AZ 85306-4660
Phone (602) 978-5900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150528000583 | AZ | Order and Referring Only - Other (Non-Physician) | 0840510111 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7132 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thielen Dental LLC | General Practice | Past | Accepting new patients |
| Dr. Farzin Allameh DDS PC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Laveen, AZ
- NPI 1649018417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1851512123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5750 W THUNDERBIRD RD",
"address_2": "SUITE F600",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853064660",
"telephone_number": "602-978-5900",
"fax_number": "602-978-5909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5750 W THUNDERBIRD RD",
"address_2": "SUITE F600",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853064660",
"telephone_number": "602-978-5900",
"fax_number": "602-978-5909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STULIC",
"first_name": "DOSITEJ",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D7132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.