Healthcare Provider Details

I. General information

NPI: 1881484285
Provider Name (Legal Business Name): JOSHUA ROBERT STONAWSKI SEMPLE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DENTAL / MEDICAL CLINIC - MCAS YUMA, YUMA, AZ
FPO AA
85365
US

IV. Provider business mailing address

DENTAL / MEDICAL CLINIC - MCAS YUMA, YUMA, AZ
FPO AA
85365
US

V. Phone/Fax

Practice location:
  • Phone: 928-269-7131
  • Fax:
Mailing address:
  • Phone: 928-269-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS111614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: