Jeffery D. Stahly, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009496A Issued in IN

Practice address

106 N Ridge Rd
Muncie, IN 47304-3739

Phone

(765) 284-2330

Fax

(765) 284-5283

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

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

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

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1902958713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6267 RED FOX RD",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460649058",
            "telephone_number": "765-778-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N RIDGE RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043739",
            "telephone_number": "765-284-2330",
            "fax_number": "765-284-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLY",
        "first_name": "JEFFERY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009496A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniella C Stafford, NP
• David Stagge, D.D.S.
• Sherry Stagge, D.D.S.
• Alexander Stahl, RBT
• Trevor Wayne Stahl
• Standing Strong
• Emily Stanisch
• Mira Stankovich
• Hannah Stanley
• Kevin Michael Stanley, RPH

• General Practice Dentistry in Muncie, IN
• Providers in Muncie, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.