MADELYN LUCILLE FLETCHER-STARK (NPI# 1528392115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528392115 |
Entity Type | Individual |
Full Name | MADELYN LUCILLE FLETCHER-STARK |
Credential | DDS |
Practice Address |
8521 Golf Course Rd Nw Ste 116 Albuquerque NM 87114-4549 |
Practice Telephone | 5058976453 |
Mailing Telephone | 5058976453 |
Enumeration Date | 2009-09-29 |
Last Update Date | 2017-10-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
DD4508 | NM | Dental Providers |
N | 1223P0700X |
Dentist Specialization: Prosthodontics |
47259 | CA | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | LICENSE NUMBER | 47259 | 01 |
Street Address |
8521 GOLF COURSE RD NW STE 116 |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87114-4549 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205901972 | Lisa Washburn Arnhart | Dentist | 8521 Golf Course Rd Nw Ste 116, Albuquerque, NM 87114-4549 | 2006-11-21 |
1063989622 | Dental House Golf Course, LLC | Clinic/Center | 8521 Golf Course Rd Nw Ste 116, Albuquerque, NM 87114-4549 | 2018-10-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891331773 | Head To Toe Wellness, LLC | Counselor | 4619 Greene Ave, Suite D, Albuquerque, NM 87114 | 2019-11-26 |
1255896353 | 32 Degrees Genuine, LLC | Counselor | 10143 4th St Nw, Albuquerque, NM 87114 | 2019-02-04 |
1548789365 | Maureen Chavez | Occupational Therapist | 10501 Golf Course, Albuquerque, NM 87114 | 2017-09-13 |
1982149043 | Professional Case Coordination Services LLC | Case Management | 4401 Aspen Glade Dr Nw, Albuquerque, NM 87114 | 2016-12-28 |
1124494323 | Geri Davis | Nurse Practitioner | 10511 Golf Course Rd Nw Ste 203, Albuquerque, NM 87114 | 2015-08-11 |
1427432111 | Marcia Nicole Cowen | Nurse Practitioner | 9210 Golfcourse Rd Nw, Albuquerque, NM 87114 | 2015-07-13 |
1013315399 | Amy Brown | Counselor | 707 Broadway Blvd. Ne, Suite 500, Albuquerque, NM 87114 | 2014-12-18 |
1851793392 | Elaine Barbara Beckett | Pharmacist | 10224 Coors-by-pass Nw, Albuquerque, NM 87114 | 2014-09-16 |
1174924344 | Sherrica Cressor | Counselor | 20 Pond Road, County Road 11, Cuba, NM 87114 | 2014-09-08 |
1427467513 | Colleen Temkin | Pharmacist | 10224 Coors By Pass Nw, Albuquerque, NM 87114 | 2014-08-04 |
Find all providers in zip 87114 |
Taxonomy Code | 1223P0700X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Prosthodontics |
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144475518 | David A. Irvin | Dentist | 6830 Montgomery Blvd. Ne, Suite C, Albuquerque, NM 87109-1455 | 2008-11-26 |
1366447898 | Marc Bernard Appelbaum | Dentist | 1801 Camino De Salud Ne, Albuquerque, NM 87102-4516 | 2005-06-21 |
1730512245 | Diana N Ulrickson | Dentist | 801 Encino Pl Ne Ste A3, Albuquerque, NM 87102-2639 | 2013-08-20 |
1194013805 | Darren Carl Norby | Dentist | 8400 Osuna Rd Ne, Suite 1c, Albuquerque, NM 87111-2087 | 2011-07-14 |
1982778387 | Phillip Allen Cook | Dentist | 8400 Osuna Rd Ne, Suite 1c, Albuquerque, NM 87111-2087 | 2006-11-17 |
1336250521 | David Ray Jimenez | Dentist | 9204 Menaul Blvd Ne, 3, Albuquerque, NM 87112-2256 | 2006-08-31 |
1831105865 | Arthur Burton Melton | Dentist | 7520 Montgomery Blvd Ne, Suite D-3, Albuquerque, NM 87109-1521 | 2006-07-31 |
1013934041 | Dai Chinh Phan | Dentist | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2006-07-16 |
1336131267 | Stephen A. Wagner | Dentist | 801 Encino Pl Ne, Suite A-3, Albuquerque, NM 87102-2612 | 2005-08-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588672752 | Ann L Ortega | Dentist | 1594 Sara Rd Se, Rio Rancho, NM 87124-1862 | 2006-08-04 |
1063478618 | Mitchell R. Wilkinson | Dentist | Po Box 187, Dulce, NM 87528-0187 | 2006-04-24 |
1841288669 | August Joseph Kaleta | Dentist | Us Highway 491 N, Shiprock, NM 87420 | 2005-10-06 |
1952810715 | Hendricks Dental Group, LLC | Dentist | 444 Saint Michaels Dr Ste B, Santa Fe, NM 87505-7674 | 2017-09-25 |
1659574176 | Marion Lawrence Larragoite | Dentist | 2904 Rodeo Park Dr E, Suite 400-b, Santa Fe, NM 87505-6305 | 2007-06-11 |
City | ALBUQUERQUE |
Zip Code | 87114 |
Please comment or provide details below to improve the information on MADELYN LUCILLE FLETCHER-STARK.
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.