Stone Lake Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18968 Issued in TX

Legal business name

STONE LAKE DENTAL

Practice address

2301 Midwestern Pkwy
Ste. #110
Wichita Falls, TX 76308-2344

Phone

(940) 692-2851

Fax

(940) 691-1520

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Rafael A Perez, D.D.S.NPI 1578780425

Title

Owner

Phone

(940) 692-2851

Specialties & licenses 1

Addresses

Other names 1

• Rafael A Perez, DDS Michael W. Spiller, Jr. DDS Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rafael Antonio Perez, D.D.S.

  • General Practice Dentistry
  • Wichita Falls, TX
  • NPI 1578780425
  NPD (past) Authorized official
• Sarah Ann Fritzsch, D.D.S.

  • General Practice Dentistry
  • Wichita Falls, TX
  • NPI 1669699427
  NPD (past)

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861619611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 MIDWESTERN PKWY",
            "address_2": "STE. #110",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082344",
            "telephone_number": "940-692-2851",
            "fax_number": "940-691-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 MIDWESTERN PKWY",
            "address_2": "STE. #110",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082344",
            "telephone_number": "940-692-2851",
            "fax_number": "940-691-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE LAKE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-692-2851",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rafael A Perez, DDS Michael W. Spiller, Jr. DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Lenae Stewart, LOT
• Tiffany A Stewart, PH.D., LPC
• Tori Stewart, LPC
• Stephanie Stockton
• Jean M Stokes, NP
• Jennifer Storey
• Nicole Joy Storseth, MD
• Stout Family Hearing, LLC
• Steven Daniel Stout, BCHIS
• Macey Straight

• General Practice Dentistry in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.