STAS VIDYAKIN (NPI# 1285292193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285292193 |
| Entity Type | Individual |
| Full Name | STAS VIDYAKIN |
| Credential | DMD |
| Practice Address |
220 Southland Dr Sikeston MO 63801-4403 |
| Mailing Address |
6738 State Highway 77 Benton MO 63736-8238 |
| Practice Telephone | 5734714167 |
| Practice Fax Number | 5734714212 |
| Mailing Telephone | 5733132500 |
| Mailing Fax Number | 5733132505 |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2020-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2019019577 | MO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 400070483 | 05 |
| Street Address |
220 SOUTHLAND DR |
| City | SIKESTON |
| State | MO |
| Zip Code | 63801-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134149065 | Dean O. Cansler | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2006-07-21 |
| 1760091524 | Rachael M Parker | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2020-07-28 |
| 1902254261 | Lindsey Mercer | Dental Hygienist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2016-05-27 |
| 1235544123 | Blake Essner | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2014-06-30 |
| 1720492895 | Rebecca Roper | Dental Hygienist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2014-06-17 |
| 1386058352 | Amber Graham | Dental Hygienist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2014-06-17 |
| 1053654038 | Ashley Zeigler | Dental Hygienist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2013-03-28 |
| 1386922920 | Pamela N Murphy | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2011-08-01 |
| 1467684183 | Liya M Kunnassery | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2009-08-13 |
| 1134340102 | Southeast Missouri Health Network | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2007-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1992212153 | Sharaye Gilmore | Social Worker | 135 Plaza Dr Suite 102, Sikeston, MO 63801 | 2018-01-09 |
| 1730606385 | Megan Leann Schlosser | Occupational Therapy Assistant | Kenny Rogers Children's Center, 300 Floyd Dr., Sikeston, MO 63801 | 2017-08-24 |
| 1780130930 | Delta South Adult Care Center LLC | Clinic/Center | 640 Colonel George E Day Parkway, Sikeston, MO 63801 | 2016-08-28 |
| 1013236421 | Missouri Delta Medical Center | Clinic/Center | 1013 North Main, Sikeston, MO 63801 | 2010-05-25 |
| 1134361868 | Sikeston Rehab, LLC | Physical Therapy Assistant | 806 S. Kingshighway, Sikeston, MO 63801 | 2009-03-26 |
| 1508066978 | Paula Kaye Beck | Occupational Therapist | 2016 Oklahoma Ave, Sikeston, MO 63801 | 2007-07-23 |
| 1740497551 | James D West | Audiologist | 903 South Kingshighway, Sikeston, MO 63801 | 2007-05-17 |
| 1619190162 | Syed Muhammad Shahab Sayeed | Psychiatry & Neurology | 1008 N Main, Missouri Delta Medical Centre, Sikeston, MO 63801 | 2007-04-11 |
| 1629195607 | Melissa A Stewart | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Dacus, Sikeston, MO 63801 | 2007-03-23 |
| Find all providers in zip 63801 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801921010 | Grant Wendell Weathers Jr. | Dentist | 405 Tanner St, Sikeston, MO 63801-4272 | 2007-02-21 |
| 1770649543 | Steven P Nast | Dentist | 801 North Main Street, Steve Nast Dds, Sikeston, MD 63801 | 2006-12-28 |
| 1548373103 | John A Leible | Dentist | 404 Tanner St, Sikeston, MO 63801-4273 | 2006-08-17 |
| 1336159821 | William Byron Dillon | Dentist | 609 S Main St, Sikeston, MO 63801-3041 | 2006-08-08 |
| 1134149065 | Dean O. Cansler | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2006-07-21 |
| 1639154800 | Larry J Anthony | Dentist | 1002 N Main St, Sikeston, MO 63801-5044 | 2005-12-10 |
| 1760091524 | Rachael M Parker | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2020-07-28 |
| 1235544123 | Blake Essner | Dentist | 220 Southland Dr, Sikeston, MO 63801-4403 | 2014-06-30 |
| 1558594630 | Mark L Trulsson | Dentist | 903 S Kingshighway St, Sikeston, MO 63801-4415 | 2009-08-24 |
| 1629237615 | G. Wendell Weathers, D.d.s., P.C. | Dentist | 405 Tanner St, Sikeston, MO 63801-4272 | 2008-06-04 |
| Find all providers in SIKESTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.