DR. MICHAEL JOHN STOLTZ (DMD) – Oral and Maxillofacial Surgery (Dentist), NPI 1417074618

DR. MICHAEL JOHN STOLTZ (DMD) is a healthcare provider. based in Fairbanks, Alaska. specializing in ORAL SURGERY. They hold the professional credentials DMD. They hold a License No. 745 (AK). The NPI Number for DR. MICHAEL JOHN STOLTZ (DMD) is 1417074618

Main info

Male
35 Years Of Experience
Name
DR. MICHAEL JOHN STOLTZ (DMD)
NPI
1417074618
Phone
(907) 452-1250
Address
3112 AIRPORT WAY
Enumeration Date
23 March 2007
Last Update Date
6 July 2023

Doctor Profile

Medical School Name
OREGON HEALTH & SCIENCES UNIV SCHOOL OF DENTISTRY
Secondary Phone
9074521250
Graduation Year
1991 (35 years ago)
PAC ID
5294014213
Group Practice PAC ID
7315226404
Professional Enrollment ID
I20231206002113
Address ID
AK997094768FA3112XWAYX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

7 ORAL SURGERY in AK

Provider Addresses for DR. MICHAEL JOHN STOLTZ (DMD)

  • 3112 AIRPORT WAY

    SUITE 1

    FAIRBANKS, AK 99709

    Phone: (907) 452-1250

    Fax: (907) 456-1307

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231206002113IOral SurgeryAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99709)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7315226404View full group profile
NameSpecialtyState
Oral SurgeryCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MICHAEL JOHN STOLTZ (DMD)?
DR. MICHAEL JOHN STOLTZ (DMD) — NPI 1417074618 — is the standard way to identify this listing.
Does the file indicate DR. MICHAEL JOHN STOLTZ (DMD) is practicing under active NPI?
Directory data currently reports DR. MICHAEL JOHN STOLTZ (DMD) as active.
What is DR. MICHAEL JOHN STOLTZ (DMD)'s primary classification?
Oral and Maxillofacial Surgery (Dentist) is the headline specialty for DR. MICHAEL JOHN STOLTZ (DMD) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MICHAEL JOHN STOLTZ (DMD)?
DR. MICHAEL JOHN STOLTZ (DMD)'s geographic hint is Fairbanks, Alaska in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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