Healthcare Provider Details

I. General information

NPI: 1083405492
Provider Name (Legal Business Name): STEVIE SMITH, DENTAL HYGIENIST, A.P.C., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1252 W NEWGROVE ST
LANCASTER CA
93534-2938
US

IV. Provider business mailing address

1252 W NEWGROVE ST
LANCASTER CA
93534-2938
US

V. Phone/Fax

Practice location:
  • Phone: 661-675-6863
  • Fax:
Mailing address:
  • Phone: 661-675-6863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: MS. STEVIE LEE SMITH
Title or Position: PRESIDENT
Credential: RDHAP, RDH, MPH
Phone: 661-646-4022