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NPI Code Detail

MEDICARE: STEPHEN J MAYO D.D.S.

MEDICARE: STEPHEN J MAYO D.D.S.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry0401004458VA

General Provider Information

NPI Number : 1609974534
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN J MAYO D.D.S.
Provider Business Mailing Address
First Line : 22 DAVIS AVE SW
Second Line :
City : LEESBURG
State : VA
Zip : 20175-3824
Country : US
Telephone Number : 703-777-3510
Fax Number :
Provider Business Practice Location Address
First Line : 22 DAVIS AVE SW
Second Line :
City : LEESBURG
State : VA
Zip : 20175-3824
Country : US
Telephone Number : 703-777-3510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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Directions to “ STEPHEN J MAYO D.D.S.” Practice Location

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