John R Stohl

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4089 Issued in ID

Practice address

530 S State St
Shelley, ID 83274

Phone

(208) 357-2400

Fax

(208) 357-2414

NPI assigned

Feb 27, 2007

Last updated

Oct 9, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Shelley Dental, Inc

  • General Practice Dentistry
  • Shelley, ID
  • NPI 1174775902
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1871620906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S STATE ST",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "83274",
            "telephone_number": "208-357-2400",
            "fax_number": "208-357-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S STATE ST",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "83274",
            "telephone_number": "208-357-2400",
            "fax_number": "208-357-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOHL",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley-Firth Quick Response Unit
• Samuel R Smith, DDS
• Snake River Eye Associates of Shelley, PLLC
• Aubrey Joy Snell, HEALTH COACH
• Kristan C Sparks, O.D.
• Stone Ridge Dental Inc.
• Melanie F. Sullivan, LMFT
• Corwin Sutherin
• Ty W. Swensen, PHARM.D.
• Rigoberto Vasquez

• General Practice Dentistry in Shelley, ID
• Providers in Shelley, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.