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NPI Code Detail

MEDICARE: SAVANNAH L STADELMAIER DDS

MEDICARE: SAVANNAH L STADELMAIER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDD9150NM

General Provider Information

NPI Number : 1699328054
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH L STADELMAIER DDS
Provider Business Mailing Address
First Line : 4730 BECKNER RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-3691
Country : US
Telephone Number : 505-989-4500
Fax Number : 505-443-8361
Provider Business Practice Location Address
First Line : 4730 BECKNER RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-3691
Country : US
Telephone Number : 505-989-4500
Fax Number : 505-443-8361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2019
Last Update Date : 01/13/2026

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