NPI Code Detail JSON Logo

1336314079 NPI number — STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC

NPI Number: 1336314079
Health Care Provider/Practitioner: STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC

Information about “1336314079” NPI (STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC) exists in 1336314079 in HTML format HTML  |  1336314079 in plain Text format TXT  |  1336314079 in PDF (Portable Document Format) PDF  |  1336314079 in an XML format XML  formats.

NPI Number : 1336314079 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336314079",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5551 WINGHAVEN BLVD. STE. 210",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "O'FALLON",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63368",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "636-978-6967",
    "MailingAddressFaxNumber": "636-978-5905",
    "FirstLinePracticeLocationAddress": "2992 HIGHWAY K",
    "SecondLinePracticeLocationAddress": "STE 133",
    "PracticeLocationAddressCityName": "O FALLON",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63368-7861",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "636-978-6967",
    "PracticeLocationAddressFaxNumber": "636-978-5905",
    "EnumerationDate": "04/24/2008",
    "LastUpdateDate": "06/28/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WISNIEWSKI",
    "AuthorizedOfficialFirstName": "LANA",
    "AuthorizedOfficialMiddleName": "S.",
    "AuthorizedOfficialTitle": "BUSINESS MANAGER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "636-978-6967",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223S0112X",
        "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
        "LicenseNumber": "011813",
        "LicenseNumberStateCode": "MO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.