Dwight Stanley, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21079 Issued in MA

Practice address

Dental Health Int
100 Everett Ave Unit 5
Chelsea, MA 02150

Phone

(617) 884-4444

Fax

(617) 884-4448

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861535650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DENTAL HEALTH INT",
            "address_2": "100 EVERETT AVE UNIT 5",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "617-884-4444",
            "fax_number": "617-884-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DENTAL HEALTH INT",
            "address_2": "100 EVERETT AVE UNIT 5",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "617-884-4444",
            "fax_number": "617-884-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205915",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Springfield Family Dental PC
• Springfield Family Dental PC
• Prisha Srivastava
• Kayla St.Sauveur
• Jaran Stallbaum, MA
• Geoffery Michael Stanley, MSW
• Star Physical Therapy
• Karissa Pamela Star
• Patrick Steacie
• Lauren Elisabeth Zenner Steele, MD

• General Practice Dentistry in Chelsea, MA
• Providers in Chelsea, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.