Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1700871118 Individual Practitioner Male Practitioner

Dr. Chad Stoller , DDS, PA-C

Dentist • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Dr. Chad Stoller, DDS, PA-C is a registered healthcare professional specializing in Dentist in Fort Wayne, IN. Practice services are available at 2828 E STATE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2828 E State Blvd

Fort Wayne, IN 468054761

Telephone 2604826689
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 2.0 Yrs
State Avg: 7.1 Yrs
Regional Practice Density
103 Specialists

Practicing in Fort Wayne, IN (1682 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-07-22
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IN 12013438A

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License MI 5601003571

Definition to come...

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License MI 5601003571

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Railroad Medicare
970021317

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1083167498
NPI 1306094354

Doctor of Dental Surgery

NPI 1780800243

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 22, 2020

Registered at 2828 E STATE BLVD, FORT WAYNE, IN 468054761 (Tel: 2604826689)

📍
Updated Business Mailing Address July 22, 2020

Registered at 2828 E STATE BLVD, FORT WAYNE, IN 468054761 (Tel: 2604826689)

👤
Provider Name / Credentials Updated July 22, 2020

Recorded as CHAD STOLLER, DDS, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2020

Dentist (License #12013438A in IN)

NPI Profile Active March 04, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location March 04, 2008

Registered at 200 JEFFERSON AVE SE, GRAND RAPIDS, MI 495034502 (Tel: 8009686866)

📍
Updated Business Mailing Address March 04, 2008

Registered at PO BOX Q, GRAND RAPIDS, MI 495014917 (Tel: 8009686866)

👤
Provider Name / Credentials Updated March 04, 2008

Recorded as CHAD STOLLER, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 04, 2008

Physician Assistant (License #5601003571 in MI)

🟢
Initial NPI Registration & Enumeration September 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700871118
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 13, 2005
Last Update: July 22, 2020
Sole Proprietor: No

Mailing Address

2828 E State Blvd

Fort Wayne, IN 468054761

Phone: 2604826689

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.