Jonah Staten, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.024483 Issued in OH

Practice address

1634 W Church St
Newark, OH 43055-1540

Phone

(740) 344-1810

Fax

(740) 344-0440

NPI assigned

May 19, 2015

Last updated

May 19, 2015By the provider in NPPES

Sex

Male

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

Enrolled in OH

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

Practice roles

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

• Moundbuilders General Dentistry

  • General Practice Dentistry
  • Newark, OH
  • NPI 1295933281
  NPD (past)
• Moundbuilders General Dentistry, DRS. Jump and Robertson LLC

  • Dental Clinic/Center
  • Newark, OH
  • NPI 1184302994
  NPD (past)

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1932588258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W CHURCH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-344-1810",
            "fax_number": "740-344-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W CHURCH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-344-1810",
            "fax_number": "740-344-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "JONAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Patrick Stambaugh, DC, CCSP
• McKenna J Stanley
• Vanessa K. Stapert, LISW
• Nicole Renea Starks, APRN, CNP
• Matthew E Starner, HIS
• Lindsay Stauffer, CDCA
• Alysha Steele
• Benjamin Stein, LSW
• Sheila Denise Stenger, PERSONAL CARE AIDE
• Hannah Elizabeth Stephen

• General Practice Dentistry in Newark, OH
• Providers in Newark, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.