Individual provider Active NPI

Russell Brian Stoch, DMD

  • Endodontics
  • North Palm Beach, FL
National Provider Identifier
1952303869
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN8991 Issued in FL
Practice address
840 US Highway 1
Ste 200
North Palm Beach, FL 33408-3830
Phone
(561) 627-4040
Fax
(561) 624-5881
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN8991 FL Primary

Addresses

Primary practice location

840 US Highway 1
Ste 200
North Palm Beach, FL 33408-3830

Mailing address

840 US Highway 1
Ste 200
North Palm Beach, FL 33408-3830
Phone (561) 627-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160407000395 FL Order and Referring Only - DentistPractitioner - Dentist 5092013094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN8991FLMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell B Stoch DMD PA Endodontics Past 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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1952303869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 US HIGHWAY 1",
            "address_2": "STE 200",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083830",
            "telephone_number": "561-627-4040",
            "fax_number": "561-624-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 US HIGHWAY 1",
            "address_2": "STE 200",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334083830",
            "telephone_number": "561-627-4040",
            "fax_number": "561-624-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCH",
        "first_name": "RUSSELL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN8991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.