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1508884396 NPI number — KASAN STEVENS D.D.S.

NPI Number: 1508884396
Health Care Provider/Practitioner: KASAN STEVENS D.D.S.

Information about “1508884396” NPI (KASAN STEVENS D.D.S.) exists in 1508884396 in HTML format HTML  |  1508884396 in plain Text format TXT  |  1508884396 in PDF (Portable Document Format) PDF  |  1508884396 in an XML format XML  formats.

NPI Number : 1508884396 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508884396",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STEVENS",
    "FirstName": "KASAN",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STEVENS-HANSBERRY",
    "OtherFirstName": "KASAN",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "D.D.S.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "11918 SUNRAY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BATON ROUGE",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "70816-5316",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "225-291-2111",
    "MailingAddressFaxNumber": "225-291-2191",
    "FirstLinePracticeLocationAddress": "11918 SUNRAY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BATON ROUGE",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "70816-5316",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "225-291-2111",
    "PracticeLocationAddressFaxNumber": "225-291-2191",
    "EnumerationDate": "07/18/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "5372",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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