Healthcare Provider Details

I. General information

NPI: 1508832585
Provider Name (Legal Business Name): STEPHANIE BETH VIDONI-HARTUNG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 W CALLE DE LAS TIENDAS DTE 125B
GREEN VALLEY AZ
85614
US

IV. Provider business mailing address

6596 N ORACLE RD
TUCSON AZ
85704
US

V. Phone/Fax

Practice location:
  • Phone: 520-399-4000
  • Fax: 520-515-9600
Mailing address:
  • Phone: 520-297-9069
  • Fax: 520-886-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD4977
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: