Active NPI
Kristy Jo Stanislav, DDS
- Dentist
- Clarksville, TN
National Provider Identifier
1992068621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9472
- Practice address
- 230 Dover Rd
Clarksville, TN 37042-4183 - Phone
- (931) 920-5000
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9472 | TN | Primary |
Addresses
Primary practice location
230 Dover Rd
Clarksville, TN 37042-4183
Mailing address
409 Savannah Trace Dr
Clarksville, TN 37043-5443
Phone (931) 338-0985
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9472 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339977600000",
"number": "1992068621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 SAVANNAH TRACE DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370435443",
"telephone_number": "931-338-0985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 DOVER RD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370424183",
"telephone_number": "931-920-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANISLAV",
"first_name": "KRISTY",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2012-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "9472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.