MEDICARE: STEPHEN DENT M.D. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207K00000X	Allergy & Immunology Physician
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician
3	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1093941601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN DENT M.D. INC.

Provider Business Mailing Address
First Line	:	2027 NEWCASTLE AVE
Second Line	:	1197 PO BOX
City	:	CARDIFF BY THE SEA
State	:	CA
Zip	:	92007-1751
Country	:	US
Telephone Number	:	760-479-2100
Fax Number	:	760-479-2101

Provider Business Practice Location Address
First Line	:	2020 CASSIA RD STE 101
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92009-4211
Country	:	US
Telephone Number	:	760-479-2100
Fax Number	:	619-858-0928

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	DAWN MCCLOSKEY
Credential	:	COPM
Telephone Number	:	760-479-2100

Provider Enumeration Date	:	06/10/2009
Last Update Date	:	02/17/2023

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Directions to “STEPHEN DENT M.D. INC. ” Practice Location

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