Individual provider Active NPI

Angelina Marie Stotelmyre, RDH

  • Dental Hygienist
  • Scottsdale, AZ
National Provider Identifier
1912676263
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
8059 Issued in AZ
Practice address
10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019
Phone
(480) 946-9103
NPI assigned
Sep 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 8059 AZ Primary

Addresses

Primary practice location

10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019

Mailing address

368 W Honey Locust Ave
Queen Creek, AZ 85140-7983
Phone (951) 870-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8059AZMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Salt River Pima-Maricopa Indian Community PastSince Sep 12, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1912676263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 W HONEY LOCUST AVE",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851407983",
            "telephone_number": "951-870-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005 E OSBORN RD BLDG 61",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852564019",
            "telephone_number": "480-946-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTELMYRE",
        "first_name": "ANGELINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "8059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.