NPIMap

Organization Active NPI

Mark W. Stagis DDS, Nathan E. Vick DDS Dental Group

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1871896753
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28987 Issued in CA
Legal business name
MARK W. STAGIS DDS, NATHAN E. VICK DDS DENTAL GROUP
Practice address
6215 N Fresno St
Suite 101
Fresno, CA 93710-5267
Phone
(559) 439-1245
Fax
(559) 439-0312
NPI assigned
Dec 14, 2010
Last updated
Dec 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Dr. Mark Stagis, DDSNPI 1093938508
Title
Dentist
Phone
(559) 439-1245

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59735 CA
General Practice Dentistry 1223G0001X 54793 CA
General Practice Dentistry 1223G0001X 28987 CA Primary

Addresses

Primary practice location

6215 N Fresno St
Suite 101
Fresno, CA 93710-5267

Mailing address

6215 N Fresno St
Suite 101
Fresno, CA 93710-5267
Phone (559) 439-1245

National Provider Directory

National Provider Directory

Locations

6215 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 432-1300

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1871896753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 N FRESNO ST",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105267",
            "telephone_number": "559-439-1245",
            "fax_number": "559-439-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 N FRESNO ST",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105267",
            "telephone_number": "559-439-1245",
            "fax_number": "559-439-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK W. STAGIS DDS, NATHAN E. VICK DDS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "STAGIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "559-439-1245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59735",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54793",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.