=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407848096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEPHEN ROSS CASH D.D.S.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 197 STONEBRIDGE BLVD
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73013-4639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-285-8600
-----------------------------------------------------
Fax | 405-285-8602
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 197 STONEBRIDGE BLVD
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73013-4639
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-285-8600
-----------------------------------------------------
Fax | 405-285-8602
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 5764
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------