Robert a Stipanov DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0011911 Issued in FL

Legal business name

ROBERT A STIPANOV DDS PA

Practice address

6060 53Rd Ave E
Suite B
Bradenton, FL 34203-9719

Phone

(941) 739-8303

NPI assigned

Apr 16, 2007

Last updated

Oct 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Antony Stipanov, DDS PANPI 1871993576

Title

President

Phone

(941) 739-8303

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Anthonly Stipanov, PA

  • Dentist
  • Bradenton, FL
  • NPI 1871993576
  NPD (past) Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381968000000",
    "number": "1871718668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 53RD AVE E",
            "address_2": "SUITE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039719",
            "telephone_number": "941-739-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 53RD AVE E",
            "address_2": "SUITE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342039719",
            "telephone_number": "941-739-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A STIPANOV DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2013-10-17",
        "status": "A",
        "authorized_official_last_name": "STIPANOV",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANTONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-739-8303",
        "authorized_official_credential": "DDS PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0011911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bradenton, FL
• Providers in Bradenton, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.