DR. STACY LYNNE POOLE (NPI# 1699920389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699920389 |
| Entity Type | Individual |
| Full Name | DR. STACY LYNNE POOLE |
| Credential | DMD |
| Practice Address |
1505 Shepard Dr Santa Maria CA 93454-7020 |
| Mailing Address |
1480 Del Mar Ave Grover Beach CA 93433-3226 |
| Practice Telephone | 8059224778 |
| Mailing Telephone | 8052028354 |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2010-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
58439 | CA | Dental Providers |
| Street Address |
1505 SHEPARD DR |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454-7020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457353922 | David Michael Cottrell | Dentist | 1505 Shepard Dr, Suite 201, Santa Maria, CA 93454-7020 | 2005-08-12 |
| 1487217691 | Santa Maria Nephrology Medical Group | Internal Medicine | 1505 Shepard Dr, Santa Maria, CA 93454-7020 | 2019-04-15 |
| 1053772244 | Hillel K Janai Pediatrics Inc | Pediatrics | 1505 Shepard Dr, 103, Santa Maria, CA 93454-7020 | 2016-03-15 |
| 1952677379 | Kishor D Popat, Md, A Professional Corp. | Internal Medicine | 1505 Shepard Dr, Ste 203, Santa Maria, CA 93454-7020 | 2012-03-29 |
| 1609181858 | Ktam Dds Dental Corp | Dentist | 1505 Shepard Dr, #201, Santa Maria, CA 93454-7020 | 2010-08-12 |
| 1710141783 | Keith H Tam | Dentist | 1505 Shepard Dr, #201, Santa Maria, CA 93454-7020 | 2008-07-17 |
| 1245370105 | Kishor D Popat | Specialist | 1505 Shepard Dr, Suite 203, Santa Maria, CA 93454-7020 | 2007-02-07 |
| 1154499838 | Eric Daniel Kirk | Dentist | 1505 Shepard Dr, Suite 202, Santa Maria, CA 93454-7020 | 2006-12-01 |
| 1447320569 | Mudit Dabral, M.d. | Internal Medicine | 1505 Shepard Dr, Suite 105, Santa Maria, CA 93454-7020 | 2006-11-08 |
| 1477623585 | Mudit Dabral | Internal Medicine | 1505 Shepard Dr, Suite 105, Santa Maria, CA 93454-7020 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235625542 | Thanhdung Khong Ng | Dentist | 201 N College Dr Ste 102, Santa Maria, CA 93454-4614 | 2018-07-10 |
| 1649435231 | Kenneth Roy Nelson | Dentist | 1505 Shepard Dr Ste 101, Santa Maria, CA 93454-7016 | 2008-07-23 |
| 1962616524 | Kirk A Specht | Dentist | 1311 S Miller St Ste 201, Santa Maria, CA 93454-6900 | 2007-05-10 |
| 1174653844 | Kalfred Gs Chun | Dentist | 1001 S Broadway, Santa Maria, CA 93454-6605 | 2007-03-06 |
| 1366539645 | Michael Arthur Sales | Dentist | 1070 E Clark Ave, Santa Maria, CA 93455-5038 | 2006-10-06 |
| 1740659812 | Jeremy Barrett | Dentist | 1311 S Miller St Ste 201, Santa Maria, CA 93454-6900 | 2015-09-18 |
| 1619261807 | Garrett Rand Criswell | Dentist | 2205 S Broadway, Santa Maria, CA 93454-7813 | 2011-06-05 |
| 1184636243 | John Michael Adam | Dentist | 1311 S Miller St, #201, Santa Maria, CA 93454 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091720 | Ellen Im Dds Inc | Dentist | 13422 Pomerado Rd Ste 201, Poway, CA 92064-3548 | 2020-10-21 |
| 1104425370 | Jack Bayraymyan Dental Group Inc. | Dentist | 2621 Zoe Ave Ste A, Huntington Park, CA 90255-4131 | 2020-10-20 |
| 1669071825 | Jack Bayraymyan Dental Group Inc. | Dentist | 418 E Glenoaks Blvd Ste 202, Glendale, CA 91207-2093 | 2020-10-20 |
| 1891394060 | Jack Bayraymyan Dental Group Inc. | Dentist | 600 S Alvarado St Ste 200-201, Los Angeles, CA 90057-3314 | 2020-10-20 |
| 1790391209 | Two Front Corp | Dentist | 2408 Grandview Ave, Venice, CA 90291-4938 | 2020-09-21 |
| 1396358453 | Bridget Powers | Dentist | 1000 Ygnacio Valley Rd, Walnut Creek, CA 94598-1812 | 2020-08-28 |
| 1144832221 | Manjeet Samra Dental Corporation | Dentist | 1700 Mchenry Ave Ste 16b, Modesto, CA 95350-4319 | 2020-08-19 |
| 1154932150 | Jacqueline Morgan Payne | Dentist | 1820 Sonoma Ave Ste 36, Santa Rosa, CA 95405-6617 | 2020-08-12 |
| 1922617802 | Andrew Levin | Dentist | 7891 Talbert Ave # 2, Huntington Beach, CA 92648-8612 | 2020-07-27 |
| 1861001885 | Robert Berger | Dentist | 2529 Via Sanchez, Palos Verdes Estates, CA 90274-2805 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MARIA |
| Zip Code | 93454 |
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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.