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NPI Code Detail

MEDICARE: JOHN EDWARD STEPHENSON DDS

MEDICARE: JOHN EDWARD STEPHENSON DDS
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 Dentistry2039NV
21223G0001XGeneral Practice Dentistry1223G0001X-2039NV

General Provider Information

NPI Number : 1699942086
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN EDWARD STEPHENSON DDS
Provider Business Mailing Address
First Line : 5642 S EASTERN AVE
Second Line : #F
City : LAS VEGAS
State : NV
Zip : 89119-2310
Country : US
Telephone Number : 702-739-9999
Fax Number : 702-739-0081
Provider Business Practice Location Address
First Line : 5642 S EASTERN AVE
Second Line : #F
City : LAS VEGAS
State : NV
Zip : 89119-2310
Country : US
Telephone Number : 702-739-9999
Fax Number : 702-739-0081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 05/14/2008

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Directions to “ JOHN EDWARD STEPHENSON DDS” Practice Location

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