Stacy M Fore, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40589 Issued in CA

Practice address

984 Plaza Dr
Grass Valley, CA 95945-9532

Phone

(530) 273-1470

Fax

(530) 272-5409

NPI assigned

Oct 17, 2006

Sex

Female

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

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Fore Dental a Professional Corporation

  • Dentist
  • Grass Valley, CA
  • NPI 1427485259
  NPD Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912087503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 PLAZA DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459532",
            "telephone_number": "530-273-1470",
            "fax_number": "530-272-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 PLAZA DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459532",
            "telephone_number": "530-273-1470",
            "fax_number": "530-272-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORE",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foothill House of Hospitality (Hospitality House)
• Foothill House of Hospitality (Hospitality House)
• Foothill Podiatry Clinic of Grass Valley Inc (Foothill Podiatry of Grass Valley, Inc)
• Sarah Ford
• Fore Dental a Professional Corporation
• Melissa Formati
• Sonya Fortakoff-Freeman
• Linda Kay Foshagen, DO
• Justin Foster
• Tara Dawn Fouch

• General Practice Dentistry in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.