Individual provider Active NPI

Stephanie Selecman Files, D.D.S.

  • General Practice Dentistry
  • Saint Joseph, MO
National Provider Identifier
1982706420
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015602 Issued in MO
Practice address
1429 Village Dr
Saint Joseph, MO 64506-2459
Phone
(816) 233-8668
Fax
(816) 233-5665
NPI assigned
Sep 4, 2006
Last updated
May 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 015602 MO Primary

Addresses

Primary practice location

1429 Village Dr
Saint Joseph, MO 64506-2459

Mailing address

1429 Village Dr
Saint Joseph, MO 64506-2459
Phone (816) 233-8668

Other identifiers 7

IdentifierTypeStateIssuer
702950OtherKSBLUE CROSS BLUE SHIELD KS
740-09253OtherALBLUE CROSS BLUE SHIELD AL
21204011OtherMOBLUE CROSS BLUE SHIELD KC
DELTA DENTALOtherMOINSURANCE I.D. NUMBER
000626516OtherPAUNITED CONCORDIA ID #
X0738842OtherCABLUE CROSS BLUE SHIELD CA
710200000000MOOtherMIBLUE CROSS BLUE SHIELD MI

Other names 1

  • Dr. Stephanie Jeanette Selecman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20160602002146 MO Order and Referring Only - DentistPractitioner - Dentist 1456641422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1982706420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062459",
            "telephone_number": "816-233-8668",
            "fax_number": "816-233-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062459",
            "telephone_number": "816-233-8668",
            "fax_number": "816-233-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILES",
        "first_name": "STEPHANIE",
        "middle_name": "SELECMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-04",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KS",
            "identifier": "702950",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "740-09253",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KC",
            "identifier": "21204011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE I.D. NUMBER",
            "identifier": "DELTA DENTAL",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID #",
            "identifier": "000626516",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD CA",
            "identifier": "X0738842",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "710200000000MO",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SELECMAN",
            "middle_name": "JEANETTE",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.