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NPI Code Detail

MEDICARE: RICHARD J. STEIN DDS, PA

MEDICARE: RICHARD J. STEIN DDS, PA
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 Dentistry5891KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679554414
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD J. STEIN DDS, PA
Provider Business Mailing Address
First Line : 208 W ROSS BLVD
Second Line : SUITE B
City : DODGE CITY
State : KS
Zip : 67801-2133
Country : US
Telephone Number : 620-225-5682
Fax Number : 620-225-5383
Provider Business Practice Location Address
First Line : 208 W ROSS BLVD
Second Line : SUITE B
City : DODGE CITY
State : KS
Zip : 67801-2133
Country : US
Telephone Number : 620-225-5682
Fax Number : 620-225-5383
Authorized Official
Title or Position : OWNER
Name : DR. RICHARD J STEIN
Credential : DDS
Telephone Number : 620-225-5682
Provider Enumeration Date : 11/09/2005
Last Update Date : 08/22/2020

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