Stephanie M Litz, DDS, MSD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12009130 Issued in IN

Practice address

100 Town Center Dr S Ste a
Mooresville, IN 46158-2322

Phone

(317) 831-5439

Fax

(317) 831-9750

NPI assigned

Apr 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stephanie Litz DDS, PC

  • Pediatric Dentistry
  • Mooresville, IN
  • NPI 1811593122
  NPD Authorized official
• Mooresville Pediatric Dentistry PC

  • Pediatric Dentistry
  • Mooresville, IN
  • NPI 1912719147
  NPD

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1902025968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N INDIANA ST",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581503",
            "telephone_number": "317-831-3370",
            "fax_number": "317-834-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TOWN CENTER DR S STE A",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461582322",
            "telephone_number": "317-831-5439",
            "fax_number": "317-831-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITZ",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12009130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300046440",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100186730A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Mooresville",
            "affiliation": "N",
            "address_1": "100 TOWN CENTER RD S",
            "address_2": "STE A",
            "city": "Mooresville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Dentistry in Mooresville, IN
• Providers in Mooresville, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.