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General NPI Number Information
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NPI Number | 1902218845
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Entity Type | Individual
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Provider Name | STEPHEN JAMES SIEDOW D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 5342 E US HIGHWAY 83 STE 5
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-9433
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Country | US
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Telephone | 956-414-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 N G ST STE 130
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City | MCALLEN
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State | TX
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Zip | 78504-6550
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Country | US
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Telephone | 956-414-7878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30645
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License Number State | TX
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